Provider Demographics
NPI:1851010946
Name:CRAWFORD, SHANNA LYNN
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:LYNN
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 1:8542 SIEGEN LN STE 6
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1940
Mailing Address - Country:US
Mailing Address - Phone:225-361-9576
Mailing Address - Fax:225-900-7277
Practice Address - Street 1:8542 SIEGEN LN STE 6
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1940
Practice Address - Country:US
Practice Address - Phone:225-361-9576
Practice Address - Fax:225-900-7277
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health