Provider Demographics
NPI:1578237533
Name:CRAVER, MARY LOUISE (MOT, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:LOUISE
Last Name:CRAVER
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:MRS
Other - First Name:MARY
Other - Middle Name:CRAVER
Other - Last Name:RUECKERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MOT, OTR/L
Mailing Address - Street 1:307 W COLUMBIA ST
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-2647
Mailing Address - Country:US
Mailing Address - Phone:571-286-9692
Mailing Address - Fax:
Practice Address - Street 1:7945 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:CABIN JOHN
Practice Address - State:MD
Practice Address - Zip Code:20818-1634
Practice Address - Country:US
Practice Address - Phone:571-286-9692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist