Provider Demographics
NPI:1609141175
Name:CRAFT, JANICE ANNETTE (OTR)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:ANNETTE
Last Name:CRAFT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-2833
Mailing Address - Country:US
Mailing Address - Phone:717-829-3024
Mailing Address - Fax:
Practice Address - Street 1:210 W SHERMAN ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-2833
Practice Address - Country:US
Practice Address - Phone:717-829-3024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-17
Last Update Date:2012-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001015L225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation