Provider Demographics
NPI:1548426232
Name:CROWDER, CATHRYNE LEIGH (OTR)
Entity Type:Individual
Prefix:MISS
First Name:CATHRYNE
Middle Name:LEIGH
Last Name:CROWDER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:LEIGH
Other - Middle Name:
Other - Last Name:CROWDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:1676 LAUDA DR
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-9776
Mailing Address - Country:US
Mailing Address - Phone:619-302-8646
Mailing Address - Fax:
Practice Address - Street 1:1676 LAUDA DR
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-9776
Practice Address - Country:US
Practice Address - Phone:619-302-8646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-01
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3419225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics