Provider Demographics
NPI:1629369137
Name:LAVENDER CROWELL, AMI (AMI LAVENDER CROWELL)
Entity Type:Individual
Prefix:MS
First Name:AMI
Middle Name:
Last Name:LAVENDER CROWELL
Suffix:
Gender:F
Credentials:AMI LAVENDER CROWELL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2327 RESERVATION RD
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-8668
Mailing Address - Country:US
Mailing Address - Phone:305-308-5008
Mailing Address - Fax:
Practice Address - Street 1:2405 28TH ST
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2484
Practice Address - Country:US
Practice Address - Phone:360-499-3508
Practice Address - Fax:916-364-5383
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-10-6910103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst