Provider Demographics
NPI:1457963373
Name:CROUCH, TAYLOR REHE (OTR/L)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:REHE
Last Name:CROUCH
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 1:400 56TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-8044
Mailing Address - Country:US
Mailing Address - Phone:304-541-5023
Mailing Address - Fax:
Practice Address - Street 1:7947 TARTAN FIELDS DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-8778
Practice Address - Country:US
Practice Address - Phone:614-530-8511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-21
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21180225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist