Provider Demographics
NPI:1114924883
Name:CRAWFORD, LAURA JANE (AUD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:JANE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 HUNTER AVE
Mailing Address - Street 2:
Mailing Address - City:FANWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07023-1030
Mailing Address - Country:US
Mailing Address - Phone:908-322-2104
Mailing Address - Fax:908-322-2631
Practice Address - Street 1:119 HUNTER AVE
Practice Address - Street 2:
Practice Address - City:FANWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07023-1030
Practice Address - Country:US
Practice Address - Phone:908-322-2104
Practice Address - Fax:908-322-2631
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00049400231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist