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General NPI Number Information
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NPI Number | 1003531096
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Entity Type | Organization
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Legal Business Name | CRAWFORD CLINICS
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 1664 KELLER PKWY STE 102
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City | KELLER
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State | TX
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Zip | 76248-3760
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Country | US
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Telephone | 817-601-5540
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Fax |
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Provider Business Mailing Address
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Address Line | 1664 KELLER PKWY STE 102
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City | KELLER
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State | TX
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Zip | 76248-3760
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHANNAN CRAWFORD
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Credential |
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Telephone | 757-651-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number |
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License Number State |
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