Provider Demographics
NPI:1982937645
Name:CROWLEY, QUINDOLA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:QUINDOLA
Middle Name:
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 MARVIN RD NE STE 305
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-5710
Mailing Address - Country:US
Mailing Address - Phone:360-402-7011
Mailing Address - Fax:360-455-7001
Practice Address - Street 1:1401 MARVIN RD NE STE 305
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-5710
Practice Address - Country:US
Practice Address - Phone:360-402-7011
Practice Address - Fax:360-455-7001
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000040631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical