Provider Demographics
NPI:1548382336
Name:CRAWFORD, KRISTIN PIROLLI
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:PIROLLI
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:M
Other - Last Name:PIROLLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1240B CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-3148
Mailing Address - Country:US
Mailing Address - Phone:843-261-1199
Mailing Address - Fax:843-821-8799
Practice Address - Street 1:1240A CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-3148
Practice Address - Country:US
Practice Address - Phone:843-821-8787
Practice Address - Fax:843-821-8799
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2019-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
SC5464225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH1791Medicaid