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General NPI Number Information
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NPI Number | 1457488603
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Entity Type | Individual
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Provider Name | MEGHAN DIANE CRAWFORD PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 4850 LOST CREEK DR
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City | GAINESVILLE
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State | GA
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Zip | 30504-9269
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Country | US
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Telephone | 626-888-1463
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Fax | 503-974-0936
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Provider Business Mailing Address
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Address Line | 5200 MEADOWS RD STE 150
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City | LAKE OSWEGO
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State | OR
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Zip | 97035-0066
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Country | US
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Telephone | 626-888-1463
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Fax | 503-974-0936
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2409
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY24764
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 004800
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License Number State | GA
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