MEDICARE: EMILEE CROWDER

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	:	1508579970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILEE CROWDER

Provider Business Mailing Address
First Line	:	410 N COLLETT AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-5301
Country	:	US
Telephone Number	:	301-787-9912
Fax Number	:

Provider Business Practice Location Address
First Line	:	2300 ROCKBROOK DR
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-8181
Country	:	US
Telephone Number	:	301-787-9912
Fax Number	:

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

Provider Enumeration Date	:	01/02/2023
Last Update Date	:	01/02/2023

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Directions to “ EMILEE CROWDER ” Practice Location

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