Provider Demographics
NPI:1841664562
Name:CRAWFORD, KRISTINA (OTR/L)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:CRAWFORD
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 1:298 BROADMOOR AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3911
Mailing Address - Country:US
Mailing Address - Phone:407-314-0211
Mailing Address - Fax:
Practice Address - Street 1:7400 RED BUG LAKE RD
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-7154
Practice Address - Country:US
Practice Address - Phone:407-971-2774
Practice Address - Fax:407-971-2776
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9068225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist