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Individual
MRS. CRYSTAL LYNN STEPHEN
Active
Individual
MRS. CRYSTAL LYNN STEPHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTR
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005266A
IN
225XP0019X
Physical Rehabilitation Occupational Therapist
31005266A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100273840
—
IN
Enumeration date
11/28/2012
Last updated
11/28/2012
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