Provider Demographics
NPI:1215733126
Name:CRAWFORD, ANGELA S
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:S
Last Name:CRAWFORD
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 SEMINOLE AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45506-3221
Mailing Address - Country:US
Mailing Address - Phone:937-717-8619
Mailing Address - Fax:
Practice Address - Street 1:1333 SEMINOLE AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45506-3221
Practice Address - Country:US
Practice Address - Phone:937-717-8619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services