Provider Demographics
NPI:1104074574
Name:CRAWFORD, GINGER
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 1/2 9TH ST
Mailing Address - Street 2:APT. #5
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-4092
Mailing Address - Country:US
Mailing Address - Phone:505-440-7809
Mailing Address - Fax:
Practice Address - Street 1:3001 HOT SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-4175
Practice Address - Country:US
Practice Address - Phone:505-425-6786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker