Provider Demographics
NPI:1437356581
Name:KNIPP, CRYSTAL ELIZABETH (MOT,OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:ELIZABETH
Last Name:KNIPP
Suffix:
Gender:F
Credentials:MOT,OTR/L
Other - Prefix:MRS
Other - First Name:CRYSTAL
Other - Middle Name:ELIZABETH
Other - Last Name:VORNDRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:1616 E 200 S
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:IN
Mailing Address - Zip Code:46701-9654
Mailing Address - Country:US
Mailing Address - Phone:260-466-0224
Mailing Address - Fax:
Practice Address - Street 1:3801 OLD BRUCEVILLE RD
Practice Address - Street 2:
Practice Address - City:VINCENNES
Practice Address - State:IN
Practice Address - Zip Code:47591-3889
Practice Address - Country:US
Practice Address - Phone:812-886-4677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001317A224Z00000X
IN31005386A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant