Provider Demographics
NPI:1053443390
Name:CRAWLEY, PAMELA CRAWLEY KAY (MS)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA CRAWLEY
Middle Name:KAY
Last Name:CRAWLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 HUNTING CRK
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-8762
Mailing Address - Country:US
Mailing Address - Phone:270-554-5752
Mailing Address - Fax:
Practice Address - Street 1:7000 CONTEST RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-8807
Practice Address - Country:US
Practice Address - Phone:270-554-5752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist