Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 5179 | NC |
NPI | 1003011420 |
---|---|
Provider Name | Ms. Celeste S Crawford |
First Address | Greenville, NC 27858-4716 |
Second Address | Greenville, NC 27858-4716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6103175 | (05) | NC |