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General NPI Number Information
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NPI Number | 1467094292
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Entity Type | Individual
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Provider Name | DIAMOND ANTONIA CRAWFORD
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Gender | Female
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Dates
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Enumeration Date | 10/14/2019
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 909 AVENUE C
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City | MARRERO
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State | LA
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Zip | 70072-3123
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Country | US
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Telephone | 504-383-7448
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Fax |
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Provider Business Mailing Address
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Address Line | 2422 WISTERIA ST
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City | NEW ORLEANS
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State | LA
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Zip | 70122-4866
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Country | US
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Telephone | 504-491-5778
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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 | 18647
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License Number State | LA
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