Provider Demographics
NPI:1528653110
Name:CRABTREE, CAMILLE
Entity type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CAMILLE
Other - Middle Name:ELIZABETH
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:264 POST OAK AVE SW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-5783
Mailing Address - Country:US
Mailing Address - Phone:336-609-0542
Mailing Address - Fax:
Practice Address - Street 1:264 POST OAK AVE SW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-5783
Practice Address - Country:US
Practice Address - Phone:336-609-0542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4025225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist