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Individual

KISSENA CRAWFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
741 MUNSON AVE, ZANESVILLE, OH 43701-5336
(740) 586-1477
Mailing address
741 MUNSON AVE, ZANESVILLE, OH 43701-5336

Taxonomy

Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
M3000577
OH
Enumeration date
06/01/2012
Last updated
06/01/2012
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