Provider Demographics
NPI:1417433210
Name:CROWE, WENDY MILLER
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:MILLER
Last Name:CROWE
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 1:1903 ARCHER WAY
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36804-8395
Mailing Address - Country:US
Mailing Address - Phone:334-559-0864
Mailing Address - Fax:
Practice Address - Street 1:1903 ARCHER WAY
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36804-8395
Practice Address - Country:US
Practice Address - Phone:334-559-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-15
Last Update Date:2018-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst