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Individual

LAQUISHA CRAWFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2127 GRAND BROOK CIR APT 1432B, ORLANDO, FL 32810-6915
(321) 301-5985
Mailing address
2127 GRAND BROOK CIR APT 1432B, ORLANDO, FL 32810-6915
(321) 301-5985

Taxonomy

Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
82-0862522
FL
Enumeration date
05/03/2018
Last updated
05/03/2018
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