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General NPI Number Information
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NPI Number | 1982628814
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Entity Type | Individual
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Provider Name | WANDA MCCRAY CRAWFORD LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 3505 VILLAGE DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-4513
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Country | US
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Telephone | 910-574-5598
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Fax |
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Provider Business Mailing Address
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Address Line | 44 VANTAGE WAY
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City | NASHVILLE
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State | TN
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Zip | 37228-1513
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Country | US
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Telephone |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C003470
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License Number State | NC
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