Provider Demographics
NPI:1144099532
Name:KRAFT, CALIE MAE (OT)
Entity type:Individual
Prefix:
First Name:CALIE
Middle Name:MAE
Last Name:KRAFT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 W MAIN ST APT C
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-1133
Mailing Address - Country:US
Mailing Address - Phone:570-616-5757
Mailing Address - Fax:
Practice Address - Street 1:620 PAXTON PL STE 102
Practice Address - Street 2:
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-8279
Practice Address - Country:US
Practice Address - Phone:717-723-8520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC019591225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist