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General NPI Number Information
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NPI Number | 1083144935
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Entity Type | Individual
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Provider Name | KATHERINE MARIE CRAWFORD MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 43 MAIN ST
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City | HEBRON
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State | CT
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Zip | 06248-1539
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Country | US
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Telephone | 774-314-0738
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Fax |
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Provider Business Mailing Address
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Address Line | 76 ORTON STREET EXT
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City | WORCESTER
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State | MA
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Zip | 01604-1986
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Country | US
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Telephone | 774-314-0738
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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