Provider Demographics
NPI:1467749796
Name:VORMWALD, MARGARET CRANE (OT)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:CRANE
Last Name:VORMWALD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:ELAINE
Other - Last Name:CRANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7503 SAULSBURY RD
Mailing Address - Street 2:
Mailing Address - City:TULLY
Mailing Address - State:NY
Mailing Address - Zip Code:13159-4427
Mailing Address - Country:US
Mailing Address - Phone:315-696-8692
Mailing Address - Fax:
Practice Address - Street 1:1710 ROUTE 13
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-9617
Practice Address - Country:US
Practice Address - Phone:315-439-1416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0009431172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker