Individual
MICHELE CRACCHIOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR
Contact information
Practice address
906 SW SAINT LUCIE WEST BLVD, #26, PORT ST LUCIE, FL 34986-1766
(772) 342-8988
(863) 467-6262
Mailing address
906 SW SAINT LUCIE WEST BLVD, #26, PORT ST LUCIE, FL 34986-1766
(772) 342-8988
(863) 467-6262
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT9550
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
885953100
—
FL
01
—
Z002J
BLUE CROSS BLUE SHIELD
FL
Enumeration date
02/14/2007
Last updated
07/09/2007
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