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Individual

TRACEY LEIGH CREWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, OTR

Contact information

Practice address
4422 EAST STATE BOULEVARD, FORT WAYNE, IN 46815-6917
(885) 324-0885
(765) 450-6664
Mailing address
3500 DEPAUW BOULEVARD, SUITE 3070, INDIANAPOLIS, IN 46268-6135
(317) 449-4833
(765) 450-6664

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
014885
OH
225XP0200X
Pediatric Occupational Therapist
Primary
31006496A
IN
225XP0200X
Pediatric Occupational Therapist
5201005313
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1015036
NBCOT CERTIFICATION
Enumeration date
08/18/2016
Last updated
12/26/2017
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