Individual
BETH K CRUMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTRL
Contact information
Practice address
2631 FOREST WAY NE, MARIETTA, GA 30066
(770) 540-0100
Mailing address
2631 FOREST WAY NE, MARIETTA, GA 30066-1492
(770) 540-0100
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT003848
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
477650451A
—
GA
Enumeration date
11/16/2006
Last updated
07/13/2018
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