MEDICARE: PROF. GERALDINE ROSE ANN CRAWLEY-WOODS PH.D.

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	1041C0700X	Clinical Social Worker	DP00941246	WV

General Provider Information

NPI Number	:	1427197771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PROF. GERALDINE ROSE ANN CRAWLEY-WOODS PH.D.

Provider Business Mailing Address
First Line	:	3349 TABLER STATION RD
Second Line	:
City	:	MARTINSBURG
State	:	WV
Zip	:	25401-5378
Country	:	US
Telephone Number	:	304-876-5337
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 FOXCROFT AVE
Second Line	:
City	:	MARTINSBURG
State	:	WV
Zip	:	25401-5341
Country	:	US
Telephone Number	:	304-267-1663
Fax Number	:

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

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	07/08/2007

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