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General NPI Number Information
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NPI Number | 1871376897
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Entity Type | Individual
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Provider Name | LAWRENCE E. CRAWFORD
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Gender | Male
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Dates
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Enumeration Date | 08/15/2023
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 296 MERCHANTS SQ
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City | DALLAS
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State | GA
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Zip | 30132-5029
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Country | US
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Telephone | 470-391-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 102 OSCAR LN
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City | DALLAS
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State | GA
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Zip | 30132-0396
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Country | US
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Telephone | 908-342-4426
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State | GA
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