Healthcare Provider Details

I. General information

NPI: 1982245189
Provider Name (Legal Business Name): ANNE LINDERMAN CRAWFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2019
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 KENWOOD AVE
ANN ARBOR MI
48103-4163
US

IV. Provider business mailing address

221 KENWOOD AVE
ANN ARBOR MI
48103-4163
US

V. Phone/Fax

Practice location:
  • Phone: 734-846-3802
  • Fax:
Mailing address:
  • Phone: 734-846-3802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6361007805
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: