Provider Demographics
NPI:1962678078
Name:MCCLIMANS, CRYSTAL DAWN
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:DAWN
Last Name:MCCLIMANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 W BAY AVE APT 111
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23503-4569
Mailing Address - Country:US
Mailing Address - Phone:757-270-7854
Mailing Address - Fax:
Practice Address - Street 1:827 NORVIEW AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23509-1540
Practice Address - Country:US
Practice Address - Phone:757-853-6281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant