Provider Demographics
NPI:1275288342
Name:CRAWFORD, NATALIE MICHELLE (PTA)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:MICHELLE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 CHILDS LN
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22308-2125
Mailing Address - Country:US
Mailing Address - Phone:912-441-0776
Mailing Address - Fax:
Practice Address - Street 1:7116 FORT HUNT RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22307-1900
Practice Address - Country:US
Practice Address - Phone:703-768-0234
Practice Address - Fax:703-768-4529
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VACP008857A225200000X
GAPTA003497225200000X
VA2306606087225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant