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NPI Code Detail

MEDICARE: AMANDA JANE CRAWLEY

MEDICARE:   AMANDA JANE CRAWLEY
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
1124Q00000XDental Hygienist8312MD

General Provider Information

NPI Number : 1891527719
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA JANE CRAWLEY
Provider Business Mailing Address
First Line : 101 MONTROSE RD
Second Line :
City : PASADENA
State : MD
Zip : 21122-2719
Country : US
Telephone Number : 667-415-3195
Fax Number :
Provider Business Practice Location Address
First Line : 4195 MOUNTAIN RD
Second Line :
City : PASADENA
State : MD
Zip : 21122-4455
Country : US
Telephone Number : 410-255-8001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2024
Last Update Date : 08/19/2024

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Directions to “ AMANDA JANE CRAWLEY ” Practice Location

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