Provider Demographics
NPI:1255915799
Name:CRAWFORD, BIANCA
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 LYNDWAY RD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-1244
Mailing Address - Country:US
Mailing Address - Phone:216-262-9760
Mailing Address - Fax:
Practice Address - Street 1:2300 LYNDWAY RD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-1244
Practice Address - Country:US
Practice Address - Phone:216-262-9760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator