Provider Demographics
NPI:1831953918
Name:CRAWFORD, ANDREA TERRY
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:TERRY
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 1:5123 CENTRAL PARK PL APT 131
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53711-9315
Mailing Address - Country:US
Mailing Address - Phone:989-493-8324
Mailing Address - Fax:
Practice Address - Street 1:345 W WASHINGTON AVE FL 5
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-2996
Practice Address - Country:US
Practice Address - Phone:608-280-2095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker