Provider Demographics
NPI:1760142020
Name:CROWDER, HANNAH GRACE (OTR/L)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:GRACE
Last Name:CROWDER
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 1:1175 BOLTON RD
Mailing Address - Street 2:
Mailing Address - City:CATAWBA
Mailing Address - State:NC
Mailing Address - Zip Code:28609-8001
Mailing Address - Country:US
Mailing Address - Phone:828-320-2990
Mailing Address - Fax:
Practice Address - Street 1:4012 HICKORY BLVD
Practice Address - Street 2:
Practice Address - City:GRANITE FALLS
Practice Address - State:NC
Practice Address - Zip Code:28630-8372
Practice Address - Country:US
Practice Address - Phone:828-212-0256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14659225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist