Individual
CHRYSTON FADEYI
Active
Individual
CHRYSTON FADEYI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT, MOT, OTR/L
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT012710
GA
225X00000X
Occupational Therapist
OT006462
GA
225X00000X
Occupational Therapist
OT17124
FL
Other
Enumeration date
12/07/2016
Last updated
06/28/2021
Update your record
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