Provider Demographics
NPI:1407115595
Name:CRAWFORD, STACEY EARL (HUMAN AND FAMILY BS)
Entity Type:Individual
Prefix:MR
First Name:STACEY
Middle Name:EARL
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:HUMAN AND FAMILY BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15211 NE 36TH ST
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-9032
Mailing Address - Country:US
Mailing Address - Phone:405-919-2999
Mailing Address - Fax:405-281-5903
Practice Address - Street 1:15211 NE 36TH ST
Practice Address - Street 2:
Practice Address - City:CHOCTAW
Practice Address - State:OK
Practice Address - Zip Code:73020-9032
Practice Address - Country:US
Practice Address - Phone:405-919-2999
Practice Address - Fax:405-281-5903
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker