Provider Demographics
NPI:1467044081
Name:YOUNG-CRAWLEY, KIARA SHARVEZ
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:SHARVEZ
Last Name:YOUNG-CRAWLEY
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 1:82 COTTON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-7513
Mailing Address - Country:US
Mailing Address - Phone:731-437-9457
Mailing Address - Fax:
Practice Address - Street 1:112 N. LIBERTY STREET
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301
Practice Address - Country:US
Practice Address - Phone:731-736-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker