Provider Demographics
NPI:1750902672
Name:CRAFT, CATHERINE (OT)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:CRAFT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:TENENBAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:2400 WISTERIA DR STE A
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-2689
Mailing Address - Country:US
Mailing Address - Phone:770-982-0102
Mailing Address - Fax:770-982-0130
Practice Address - Street 1:1640 JESSE JEWELL PKWY NE STE 1A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2613
Practice Address - Country:US
Practice Address - Phone:770-536-9300
Practice Address - Fax:770-536-9389
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT007585225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist