Individual
KATIE DANIELLE CRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1515 LAKE HAVASU AVE N, LAKE HAVASU CITY, AZ 86404-1177
(928) 854-5439
Mailing address
1515 LAKE HAVASU AVE N, LAKE HAVASU CITY, AZ 86404-1177
(928) 854-5439
Taxonomy
Speciality
Code
Description
License number
State
224ZF0002X
Feeding, Eating & Swallowing Occupational Therapy Assistant
Primary
OTA046672
AZ
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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