Provider Demographics
NPI:1467626812
Name:BOCHER, CRYSTAL KIMBERLY (MS OTR)
Entity Type:Individual
Prefix:MISS
First Name:CRYSTAL
Middle Name:KIMBERLY
Last Name:BOCHER
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53094-4849
Mailing Address - Country:US
Mailing Address - Phone:920-248-1394
Mailing Address - Fax:
Practice Address - Street 1:95 MAHALANI ST
Practice Address - Street 2:STE 19A
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793
Practice Address - Country:US
Practice Address - Phone:808-244-7467
Practice Address - Fax:808-242-4762
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist