Provider Demographics
NPI:1871831719
Name:CRIPE, LACI (MOT, OTR)
Entity Type:Individual
Prefix:MRS
First Name:LACI
Middle Name:
Last Name:CRIPE
Suffix:
Gender:F
Credentials:MOT, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 N COUNTY RD 800 W
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47334
Mailing Address - Country:US
Mailing Address - Phone:765-644-0500
Mailing Address - Fax:
Practice Address - Street 1:9000 N COUNTY RD 800 W
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:IN
Practice Address - Zip Code:47334
Practice Address - Country:US
Practice Address - Phone:765-644-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-28
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31005425A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist