Provider Demographics
NPI:1093754426
Name:CRABTREE, MARIAH P (AUD)
Entity Type:Individual
Prefix:
First Name:MARIAH
Middle Name:P
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1542
Mailing Address - Country:US
Mailing Address - Phone:330-762-8959
Mailing Address - Fax:
Practice Address - Street 1:395 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1542
Practice Address - Country:US
Practice Address - Phone:330-762-8959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01103231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00316663OtherRRMC IND#
MDKR60N931Medicare PIN