Provider Demographics
NPI:1922867753
Name:CRUMP, YVETTE M (LMT)
Entity Type:Individual
Prefix:MISS
First Name:YVETTE
Middle Name:M
Last Name:CRUMP
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4451 BRAMBLE LN APT 520
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-3047
Mailing Address - Country:US
Mailing Address - Phone:469-891-1524
Mailing Address - Fax:
Practice Address - Street 1:7777 WARREN PWKY ROOM 133
Practice Address - Street 2:200
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034
Practice Address - Country:US
Practice Address - Phone:469-363-6635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT135603225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist