Individual
SUSAN ELAINE CRANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT-L
Contact information
Practice address
5304 RINCON RD NW, ALBUQUERQUE, NM 87105-1763
(505) 836-5047
(505) 883-3938
Mailing address
5304 RINCON RD NW, ALBUQUERQUE, NM 87105-1763
(505) 836-5047
(505) 883-3938
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1414
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000L3936
—
NM
Enumeration date
06/29/2007
Last updated
07/08/2007
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