Provider Demographics
NPI:1578692943
Name:CROME, ERIN RENAE (MOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:RENAE
Last Name:CROME
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8602 WESTMORELAND LAKE DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-5746
Mailing Address - Country:US
Mailing Address - Phone:815-762-3448
Mailing Address - Fax:704-237-4107
Practice Address - Street 1:17111 KENTON DR STE 206B
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5650
Practice Address - Country:US
Practice Address - Phone:704-237-4105
Practice Address - Fax:704-237-4107
Is Sole Proprietor?:No
Enumeration Date:2007-03-03
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.007272225X00000X
NC12479225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12479OtherNCBOT