Individual
MISS CHARLENE L CRUMEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 N 3RD ST, LEESVILLE, LA 71446-4014
(337) 239-3334
(337) 239-3336
Mailing address
112 N 3RD ST, LEESVILLE, LA 71446-4014
(337) 239-3334
(337) 239-3336
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
16276304
TX
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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