Individual
DOMINIQUE SUZANNE CRAWFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4645 PACHECO BLVD, MARTINEZ, CA 94553-3625
(925) 646-9270
(925) 646-9276
Mailing address
PO BOX 1109, MARTINEZ, CA 94553-0110
(925) 646-9270
(925) 646-9276
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
070012BN
CA
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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