Individual
MRS. TARA MICHELE CREWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTRL
Contact information
Practice address
1049 CHENA RD APT 9, FORT WAINWRIGHT, AK 99703-1322
(907) 356-1319
Mailing address
1049 CHENA RD APT 9, FORT WAINWRIGHT, AK 99703-1322
(907) 356-1319
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1711
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OT 1711
—
AK
Enumeration date
01/26/2007
Last updated
07/08/2007
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