Provider Demographics
NPI:1548587009
Name:CRAWFORD, RUBY LEE (LPC)
Entity Type:Individual
Prefix:
First Name:RUBY
Middle Name:LEE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1147 HERMAN LODGE BLVD
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30830-7622
Mailing Address - Country:US
Mailing Address - Phone:706-871-2892
Mailing Address - Fax:
Practice Address - Street 1:1147 HERMAN LODGE BLVD
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:GA
Practice Address - Zip Code:30830-7622
Practice Address - Country:US
Practice Address - Phone:706-871-2892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional