Provider Demographics
NPI:1578825337
Name:CRAWFORD, DAWN A
Entity Type:Individual
Prefix:MS
First Name:DAWN
Middle Name:A
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 1:205 MISTY HILLS LN
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-6156
Mailing Address - Country:US
Mailing Address - Phone:914-625-3438
Mailing Address - Fax:
Practice Address - Street 1:14 STURBRIDGE CT
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-1032
Practice Address - Country:US
Practice Address - Phone:845-623-3658
Practice Address - Fax:845-623-1368
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency