Healthcare Provider Details

I. General information

NPI: 1902036247
Provider Name (Legal Business Name): EMILY B CRAWFORD-THOMPSON PHD, LP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY CRAWFORD

II. Dates (important events)

Enumeration Date: 07/21/2009
Last Update Date: 06/05/2020
Certification Date: 06/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 BERRYWOOD DR STE 203
COLUMBIA MO
65201-6515
US

IV. Provider business mailing address

1900 N PROVIDENCE RD STE 327
COLUMBIA MO
65202-3710
US

V. Phone/Fax

Practice location:
  • Phone: 573-777-8330
  • Fax:
Mailing address:
  • Phone: 573-818-7010
  • Fax: 573-818-7012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2008034836
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: