Provider Demographics
NPI:1518173210
Name:CRESPO, CLARA (OCUPATIONAL TERAPHY)
Entity Type:Individual
Prefix:MRS
First Name:CLARA
Middle Name:
Last Name:CRESPO
Suffix:
Gender:F
Credentials:OCUPATIONAL TERAPHY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BARRIO PUNTAS
Mailing Address - Street 2:HC-01 BOX 4205
Mailing Address - City:RINCON
Mailing Address - State:PR
Mailing Address - Zip Code:00677-9705
Mailing Address - Country:US
Mailing Address - Phone:787-823-8037
Mailing Address - Fax:787-833-1371
Practice Address - Street 1:CENTRO SALUD MENTAL DE MAYAGUEZ
Practice Address - Street 2:410 AVE HOSTOS SUITE 7
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1522
Practice Address - Country:US
Practice Address - Phone:787-833-0663
Practice Address - Fax:787-833-1371
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR000070224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant