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General NPI Number Information
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NPI Number | 1841408606
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Entity Type | Individual
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Provider Name | MS. TASHIKA CRAWLEY
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Gender | Female
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4319 COVINGTON HWY SUITE 214
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City | DECATUR
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State | GA
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Zip | 30035-1210
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Country | US
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Telephone | 404-284-1911
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Fax |
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Provider Business Mailing Address
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Address Line | 930 MAPLE LEAF RDG
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City | JONESBORO
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State | GA
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Zip | 30238-7900
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Country | US
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Telephone | 770-603-8836
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC004608
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License Number State | GA
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