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General NPI Number Information
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NPI Number | 1629052261
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Entity Type | Individual
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Provider Name | TANYA L CREWS LPC, NCC, RPT-S
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Gender | Female
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 16100 CHESTERFIELD PKWY W SUITE 215
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City | CHESTERFIELD
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State | MO
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Zip | 63017-4871
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Country | US
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Telephone | 636-728-0510
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Fax | 636-728-0511
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Provider Business Mailing Address
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Address Line | 16622 HIGHLAND SUMMIT DR
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City | WILDWOOD
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State | MO
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Zip | 63011-5423
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Country | US
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Telephone | 636-728-0510
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Fax | 636-728-0511
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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