Provider Demographics
NPI:1275041840
Name:CROWL, JOANNA (MA)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:CROWL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7545 VETERANS DR
Mailing Address - Street 2:
Mailing Address - City:RAMSEY
Mailing Address - State:MN
Mailing Address - Zip Code:55303-7500
Mailing Address - Country:US
Mailing Address - Phone:612-467-1100
Mailing Address - Fax:
Practice Address - Street 1:7545 VETERANS DR
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:MN
Practice Address - Zip Code:55303-7500
Practice Address - Country:US
Practice Address - Phone:612-467-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP6943103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical