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NPI Code Detail

MEDICARE: TAYLOR LEEANN CRAWFORD

MEDICARE: TAYLOR LEEANN CRAWFORD
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
1106S00000XBehavior Technician
2106S00000XBehavior TechnicianRBT-22-206940GA

General Provider Information

NPI Number : 1669120465
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR LEEANN CRAWFORD
Provider Business Mailing Address
First Line : 225 GLOUCESTER DR
Second Line :
City : MIDWAY
State : GA
Zip : 31320-3461
Country : US
Telephone Number : 912-432-3151
Fax Number :
Provider Business Practice Location Address
First Line : 506 N MAIN ST
Second Line :
City : HINESVILLE
State : GA
Zip : 31313-2512
Country : US
Telephone Number : 615-560-6622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2022
Last Update Date : 08/18/2023

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Directions to “ TAYLOR LEEANN CRAWFORD ” Practice Location

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