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NPI Code Detail

MEDICARE: MADREIA CRAWFORD

MEDICARE: MADREIA CRAWFORD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2225C00000XRehabilitation Counselor

General Provider Information

NPI Number : 1245512029
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADREIA CRAWFORD
Provider Business Mailing Address
First Line : 2620 REGATTA DR STE 102
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-6892
Country : US
Telephone Number : 702-352-8925
Fax Number : 702-352-8925
Provider Business Practice Location Address
First Line : 2620 REGATTA DR STE 102
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-6892
Country : US
Telephone Number : 702-352-8925
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2011
Last Update Date : 10/01/2019

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Directions to “ MADREIA CRAWFORD ” Practice Location

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