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General NPI Number Information
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NPI Number | 1902866924
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Entity Type | Individual
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Provider Name | LEIF C. CROWE PH.D.
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 06/12/2011
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Provider Practice Location Address
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Address Line | 318A E MAIN ST
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City | HAVELOCK
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State | NC
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Zip | 28532-2214
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Country | US
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Telephone | 252-444-1711
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Fax | 252-444-0809
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Provider Business Mailing Address
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Address Line | 318A E MAIN ST
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City | HAVELOCK
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State | NC
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Zip | 28532-2214
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Country | US
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Telephone | 252-444-1033
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Fax | 252-444-0809
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 2363
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License Number State | NC
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