Provider Demographics
NPI:1891130175
Name:MCCRARY, ELIZABETH GAIL (OTR/L)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GAIL
Last Name:MCCRARY
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 1:301 E CAMPERDOWN WAY
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2910
Mailing Address - Country:US
Mailing Address - Phone:864-355-3100
Mailing Address - Fax:864-355-9829
Practice Address - Street 1:200 GOODRICH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-5463
Practice Address - Country:US
Practice Address - Phone:864-355-4840
Practice Address - Fax:864-355-3406
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC339225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist