Provider Demographics
NPI:1285758359
Name:CREEDE, ISABEL A (OTRL)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:A
Last Name:CREEDE
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:ISABEL
Other - Middle Name:A
Other - Last Name:ROSARIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTRL
Mailing Address - Street 1:6909 WOODHUE DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-9146
Mailing Address - Country:US
Mailing Address - Phone:336-509-1501
Mailing Address - Fax:
Practice Address - Street 1:1795 WESTCHESTER DR
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-7008
Practice Address - Country:US
Practice Address - Phone:336-888-4608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5134225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist