Provider Demographics
NPI:1346705746
Name:AKERSON, CRAE R (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:CRAE
Middle Name:R
Last Name:AKERSON
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 DEACON HILL RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-3011
Mailing Address - Country:US
Mailing Address - Phone:203-219-9497
Mailing Address - Fax:203-569-4998
Practice Address - Street 1:30 MYANO LN FL 2
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-4532
Practice Address - Country:US
Practice Address - Phone:203-219-9497
Practice Address - Fax:203-569-4998
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-10
Last Update Date:2019-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002634225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics