MEDICARE: MS. STEPHANIE SUZANNE CROWE M.S.

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1376845867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE SUZANNE CROWE M.S.

Provider Business Mailing Address
First Line	:	1813 CECIL WEBB PL
Second Line	:
City	:	LIVE OAK
State	:	FL
Zip	:	32060-8336
Country	:	US
Telephone Number	:	386-842-5555
Fax Number	:

Provider Business Practice Location Address
First Line	:	1813 CECIL WEBB PL
Second Line	:
City	:	LIVE OAK
State	:	FL
Zip	:	32060-8336
Country	:	US
Telephone Number	:	386-842-5555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2010
Last Update Date	:	12/03/2010

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