Organization
MINERAL AREA PSYCHIATRIC SERVICES LLC
Active
Organization
MINERAL AREA PSYCHIATRIC SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GABRIEL E CRAWFORD PMHNP-BC (PMHNP)
(573) 330-6468
Entity
Organization
Contact information
Practice address
203 S WASHINGTON ST, FARMINGTON, MO 63640-1836
(573) 664-1047
Mailing address
203 S WASHINGTON ST, FARMINGTON, MO 63640-1836
(573) 664-1047
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160318081127359
—
MO
Enumeration date
04/06/2017
Last updated
12/29/2024
Update your record
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