Provider Demographics
NPI:1659444644
Name:CRAWFORD, MARIEKE (PT)
Entity type:Individual
Prefix:
First Name:MARIEKE
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7417 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-8205
Mailing Address - Country:US
Mailing Address - Phone:225-926-2400
Mailing Address - Fax:225-926-2470
Practice Address - Street 1:7417 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-8205
Practice Address - Country:US
Practice Address - Phone:225-926-2400
Practice Address - Fax:225-926-2470
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA01455F225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist