Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003200510 |
---|---|
Provider Name | Lesley Anne Wingate Crawford |
First Address | Chattanooga, TN 37421-1688 |
Second Address | Chattanooga, TN 37421-1688 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2015 |
Last Update Date | 23/03/2015 |