Provider Demographics
NPI:1568548600
Name:MCCRABB, JENNIFER LYNN (ATC)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:MCCRABB
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 DEERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PEQUEA
Mailing Address - State:PA
Mailing Address - Zip Code:17565-9625
Mailing Address - Country:US
Mailing Address - Phone:717-284-3523
Mailing Address - Fax:
Practice Address - Street 1:1107 VILLAGE RD
Practice Address - Street 2:
Practice Address - City:LAMPETER
Practice Address - State:PA
Practice Address - Zip Code:17537-0428
Practice Address - Country:US
Practice Address - Phone:717-464-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART 000829A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer