Provider Demographics
NPI:1447771738
Name:CRAYTON, SALINA CLARECE (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:SALINA
Middle Name:CLARECE
Last Name:CRAYTON
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:SALINA
Other - Middle Name:CLARECE
Other - Last Name:DIOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LAT, ATC
Mailing Address - Street 1:5448 JANET LN
Mailing Address - Street 2:
Mailing Address - City:AUSTELL
Mailing Address - State:GA
Mailing Address - Zip Code:30106-7919
Mailing Address - Country:US
Mailing Address - Phone:678-471-2088
Mailing Address - Fax:
Practice Address - Street 1:700 COBB PKWY N
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-2404
Practice Address - Country:US
Practice Address - Phone:678-471-2088
Practice Address - Fax:678-471-2088
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0008042255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer