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NPI Code Detail

MEDICARE: MS. DEBORA A CRUTCHFIELD LMSW

MEDICARE: MS. DEBORA A CRUTCHFIELD LMSW
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
11041C0700XClinical Social Worker44SLO5734100NJ

General Provider Information

NPI Number : 1528307568
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBORA A CRUTCHFIELD LMSW
Provider Business Mailing Address
First Line : 2 HILLCREST TER
Second Line :
City : EAST ORANGE
State : NJ
Zip : 07018-2308
Country : US
Telephone Number : 973-399-1049
Fax Number :
Provider Business Practice Location Address
First Line : 37 EVERGREEN PL
Second Line :
City : EAST ORANGE
State : NJ
Zip : 07018-2154
Country : US
Telephone Number : 973-639-5031
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2013
Last Update Date : 02/22/2013

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