Provider Demographics
NPI:1295846475
Name:CREWS, SANDRA LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LYNN
Last Name:CREWS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SANDY
Other - Middle Name:ANGUS
Other - Last Name:CREWS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:3223 EAST 31ST STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-7611
Mailing Address - Country:US
Mailing Address - Phone:918-749-6935
Mailing Address - Fax:
Practice Address - Street 1:3223 EAST 31ST STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-7611
Practice Address - Country:US
Practice Address - Phone:918-749-6935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK684103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
7924041OtherAETNA
020618OtherMHN