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General NPI Number Information
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NPI Number | 1326867060
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Entity Type | Individual
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Provider Name | LATEESHA CRAWFORD
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Gender | Female
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 23318 130TH AVE
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City | ROSEDALE
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State | NY
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Zip | 11422-1102
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Country | US
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Telephone | 888-293-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 13447 166TH PL APT 3G
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City | JAMAICA
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State | NY
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Zip | 11434-3834
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Country | US
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Telephone | 718-207-5237
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 131135
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License Number State | NY
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