Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 106S00000X | Behavior Technician | ||
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1245512029 |
---|---|
Provider Name | Madreia Crawford |
First Address | Las Vegas, NV 89128-6892 |
Second Address | Las Vegas, NV 89128-6892 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2011 |
Last Update Date | 01/10/2019 |