Provider Demographics
NPI:1376847848
Name:CRUMPLEY, DIANE MARIE
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:MARIE
Last Name:CRUMPLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21982 ROSEMARY RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-3144
Mailing Address - Country:US
Mailing Address - Phone:708-336-9468
Mailing Address - Fax:
Practice Address - Street 1:21982 ROSEMARY RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-3144
Practice Address - Country:US
Practice Address - Phone:708-336-9468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-27
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor