Stephanie Criswell

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA001167 Issued in GA

Practice address

1312 Trees of Kennesaw Pkwy NW
Kennesaw, GA 30152-7657

Phone

(814) 574-5460

NPI assigned

Nov 21, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353628800000",
    "number": "1417291980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 TREES OF KENNESAW PKWY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527657",
            "telephone_number": "814-574-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 TREES OF KENNESAW PKWY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527657",
            "telephone_number": "814-574-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRISWELL",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-21",
        "last_updated": "2012-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "OTA001167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emily Sarah Croft, LPC
• Candace Cronan, DMD
• Julia Abigail Cross
• Yvette Stepheus Crossing, MD

• Occupational Therapy Assistant in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Occupational Therapy Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.