Provider Demographics
NPI:1700206117
Name:CRILLEY, BARBARA (OTR/L)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:CRILLEY
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:PO BOX 42602
Mailing Address - Street 2:
Mailing Address - City:FLINTON
Mailing Address - State:PA
Mailing Address - Zip Code:16640-2602
Mailing Address - Country:US
Mailing Address - Phone:814-687-3952
Mailing Address - Fax:
Practice Address - Street 1:102 LARK LANE
Practice Address - Street 2:
Practice Address - City:FLINTON
Practice Address - State:PA
Practice Address - Zip Code:16640-1602
Practice Address - Country:US
Practice Address - Phone:814-330-1239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2014-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1434225X00000X
PAOC006217L225X00000X
NJ46TR00521800225X00000X
OH007693225X00000X
MD05918225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist