Provider Demographics
NPI:1679830582
Name:CRYER, CALVIN LEON
Entity Type:Individual
Prefix:MR
First Name:CALVIN
Middle Name:LEON
Last Name:CRYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606 KIRKMAN ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-6247
Mailing Address - Country:US
Mailing Address - Phone:337-263-0819
Mailing Address - Fax:337-240-8397
Practice Address - Street 1:1606 KIRKMAN ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-6247
Practice Address - Country:US
Practice Address - Phone:337-263-0819
Practice Address - Fax:337-240-8397
Is Sole Proprietor?:No
Enumeration Date:2012-04-16
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst