Provider Demographics
NPI:1194691196
Name:CRANDALL, PARKER ELIZABETH (OTRL)
Entity type:Individual
Prefix:
First Name:PARKER
Middle Name:ELIZABETH
Last Name:CRANDALL
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 TACONIC LAKE RD
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12138-5714
Mailing Address - Country:US
Mailing Address - Phone:802-447-1547
Mailing Address - Fax:
Practice Address - Street 1:160 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-2279
Practice Address - Country:US
Practice Address - Phone:802-447-1547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-15
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist