Provider Demographics
NPI:1386374684
Name:CRATES, CAROLYN MARIE (COTA/L)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:MARIE
Last Name:CRATES
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 CABIN LN
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2500
Mailing Address - Country:US
Mailing Address - Phone:412-508-0471
Mailing Address - Fax:
Practice Address - Street 1:800 N BELL AVE STE 200
Practice Address - Street 2:
Practice Address - City:CARNEGIE
Practice Address - State:PA
Practice Address - Zip Code:15106-4330
Practice Address - Country:US
Practice Address - Phone:412-621-6151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP010261224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant