Provider Demographics
NPI:1689725558
Name:CRIGHTON, DIANA CANTU (OTR)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:CANTU
Last Name:CRIGHTON
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 1:706 WELLERBURN AVE
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-1428
Mailing Address - Country:US
Mailing Address - Phone:410-222-6942
Mailing Address - Fax:
Practice Address - Street 1:200 SCOTT AVE
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-7760
Practice Address - Country:US
Practice Address - Phone:410-222-6940
Practice Address - Fax:410-222-9943
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02380225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist