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General NPI Number Information
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NPI Number | 1194818096
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Entity Type | Individual
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Provider Name | MARIE EILEEN CRAWFORD PHD
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Gender | Female
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 02/16/2009
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Provider Practice Location Address
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Address Line | 739 BLUFF CITY HWY SUITE 5
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City | BRISTOL
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State | TN
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Zip | 37620-4637
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Country | US
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Telephone | 423-217-1097
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Fax | 423-217-1069
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Provider Business Mailing Address
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Address Line | 739 BLUFF CITY HWY SUITE 5
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City | BRISTOL
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State | TN
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Zip | 37620-4637
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Country | US
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Telephone | 423-217-1097
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Fax | 423-217-1069
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC1757
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LMHC2593
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License Number State | FL
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