Provider Demographics
NPI:1457814089
Name:CREASY, KASEY
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:
Last Name:CREASY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2398 MORGANS MILL RD
Mailing Address - Street 2:
Mailing Address - City:GOODVIEW
Mailing Address - State:VA
Mailing Address - Zip Code:24095-2772
Mailing Address - Country:US
Mailing Address - Phone:540-293-4791
Mailing Address - Fax:
Practice Address - Street 1:6515 WILLIAMSON RD
Practice Address - Street 2:
Practice Address - City:HOLLINS
Practice Address - State:VA
Practice Address - Zip Code:24019-4629
Practice Address - Country:US
Practice Address - Phone:540-366-2243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119008040225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist