Individual
CARLIE CREQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
8577 TOWNSHIP ROAD 32, JENERA, OH 45841-8908
(419) 721-9033
Mailing address
8577 TOWNSHIP ROAD 32, JENERA, OH 45841-8908
(419) 721-9033
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.05815
OH
Other
Enumeration date
08/18/2014
Last updated
08/18/2014
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