MEDICARE: JACQUELINE AUDREY CROWE

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	106S00000X	Behavior Technician		NJ

General Provider Information

NPI Number	:	1821954942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACQUELINE AUDREY CROWE

Provider Business Mailing Address
First Line	:	1237 CROSSING WAY
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-4739
Country	:	US
Telephone Number	:	973-897-3478
Fax Number	:

Provider Business Practice Location Address
First Line	:	1237 CROSSING WAY
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-4739
Country	:	US
Telephone Number	:	973-897-3478
Fax Number	:

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

Provider Enumeration Date	:	01/02/2026
Last Update Date	:	01/02/2026

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Directions to “ JACQUELINE AUDREY CROWE ” Practice Location

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