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General NPI Number Information
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NPI Number | 1982975413
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Entity Type | Individual
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Provider Name | MINNIE JOYCE CRAWFORD L.P.C., L.M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 100 N HICKORY ST
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City | VIDALIA
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State | LA
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Zip | 71373-3315
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Country | US
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Telephone | 318-372-3134
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Fax | 318-336-7112
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Provider Business Mailing Address
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Address Line | 120 HIGHWAY 921
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City | CLAYTON
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State | LA
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Zip | 71326-4701
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Country | US
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Telephone | 318-389-6722
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Fax | 318-389-6722
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2542
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License Number State | LA
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