Provider Demographics
NPI:1740575034
Name:SCHAAF, CRYSTAL SUE (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:SUE
Last Name:SCHAAF
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:SUE
Other - Last Name:AMMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3739 CRESTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53527-9533
Mailing Address - Country:US
Mailing Address - Phone:608-513-6186
Mailing Address - Fax:
Practice Address - Street 1:6630 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETON
Practice Address - State:WI
Practice Address - Zip Code:53562-3036
Practice Address - Country:US
Practice Address - Phone:608-263-8412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4885-26225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist