Healthcare Provider Details

I. General information

NPI: 1447486865
Provider Name (Legal Business Name): CROWLEY THERAPY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2009
Last Update Date: 08/17/2023
Certification Date: 08/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 ELTON RD SUITE I
JENNINGS LA
70546-4100
US

IV. Provider business mailing address

1113 E NORTHERN AVE
CROWLEY LA
70526-3035
US

V. Phone/Fax

Practice location:
  • Phone: 337-824-5488
  • Fax: 337-824-5494
Mailing address:
  • Phone: 337-783-7100
  • Fax: 337-783-7104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: TRACI H PREJEAN
Title or Position: OFFICE ADMINISTRATOR
Credential: CMM
Phone: 337-824-5488