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NPI Code Detail

MEDICARE: MA'RESIA CRUMP

MEDICARE: MA'RESIA CRUMP
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
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1457191686
Entity Type Code : Individual
Provider Name (Legal Business Name) : MA'RESIA CRUMP
Provider Business Mailing Address
First Line : 2197 S UECKER LN APT 1124
Second Line :
City : LEWISVILLE
State : TX
Zip : 75067-7809
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4100 ALPHA RD STE 1150
Second Line :
City : DALLAS
State : TX
Zip : 75244-4335
Country : US
Telephone Number : 214-771-8014
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2024
Last Update Date : 05/27/2024

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Directions to “ MA'RESIA CRUMP ” Practice Location

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