Provider Demographics
NPI:1750994067
Name:CROWLEY, DANA L
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:L
Last Name:CROWLEY
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 1:6662 RT 109
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05442
Mailing Address - Country:US
Mailing Address - Phone:802-798-2990
Mailing Address - Fax:
Practice Address - Street 1:22 RACEWAY RD
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:VT
Practice Address - Zip Code:05465-2100
Practice Address - Country:US
Practice Address - Phone:802-798-2990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist