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NPI Code Detail

MEDICARE: COLLEEN CRAWFORD LADC

MEDICARE: COLLEEN CRAWFORD LADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1457498099
Entity Type Code : Individual
Provider Name (Legal Business Name) : COLLEEN CRAWFORD LADC
Provider Business Mailing Address
First Line : 24 DUNN ST
Second Line :
City : AUBURN
State : ME
Zip : 04210-6821
Country : US
Telephone Number : 207-784-2901
Fax Number :
Provider Business Practice Location Address
First Line : 24 DUNN ST
Second Line :
City : AUBURN
State : ME
Zip : 04210-6821
Country : US
Telephone Number : 207-784-2901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 06/12/2014

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Directions to “ COLLEEN CRAWFORD LADC” Practice Location

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