Provider Demographics
NPI:1245775055
Name:CRAWFORD, DARCIE MARIE (BCBA)
Entity Type:Individual
Prefix:
First Name:DARCIE
Middle Name:MARIE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2130 MENDON RD # 3234
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-3844
Mailing Address - Country:US
Mailing Address - Phone:401-426-3234
Mailing Address - Fax:
Practice Address - Street 1:225 NEWMAN AVE
Practice Address - Street 2:
Practice Address - City:RUMFORD
Practice Address - State:RI
Practice Address - Zip Code:02916-1218
Practice Address - Country:US
Practice Address - Phone:401-426-3234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-03
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI61103K00000X
MA1388103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst