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Individual

MICHELENE CRAFT-MAYNOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTRL, CHT

Contact information

Practice address
400 CAMARILLO TECATE, SUITE 106, CAMARILLO, CA 93012
(805) 445-1222
(805) 445-1297
Mailing address
400 CAMARILLO TECATE, SUITE 106, CAMARILLO, CA 93012
(805) 445-1222
(805) 445-1297

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
OT1271
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OT0012710
BLUE SHIELD
CA
Enumeration date
02/21/2007
Last updated
07/22/2021
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