Provider Demographics
NPI:1447625934
Name:DEMBY, CRAIG (MA, OTR/L)
Entity type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:
Last Name:DEMBY
Suffix:
Gender:M
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:892 BLUEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8274
Mailing Address - Country:US
Mailing Address - Phone:561-329-1855
Mailing Address - Fax:
Practice Address - Street 1:892 BLUEBERRY DR
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-8274
Practice Address - Country:US
Practice Address - Phone:561-329-1855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 2347225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist