Provider Demographics
NPI:1518546290
Name:CRAWFORD, DEBORAH ANN
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:CRAWFORD
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 1:2700 TURLEY PL APT 3
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-7526
Mailing Address - Country:US
Mailing Address - Phone:405-635-4574
Mailing Address - Fax:
Practice Address - Street 1:3033 N WALNUT AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-2832
Practice Address - Country:US
Practice Address - Phone:405-232-9804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist