Provider Demographics
NPI:1619348893
Name:CRAVEN, KAREN MCINTOSH (OTR/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:MCINTOSH
Last Name:CRAVEN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5880 STATE ROUTE 48
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-7842
Mailing Address - Country:US
Mailing Address - Phone:812-584-8862
Mailing Address - Fax:
Practice Address - Street 1:260 NORTHLAND BLVD 114-G
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-4917
Practice Address - Country:US
Practice Address - Phone:812-584-8862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2015-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31005028A225X00000X
OH006879225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist