Provider Demographics
NPI:1306632823
Name:CRAWFORD, JAMIE (LMT, MTI)
Entity type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LMT, MTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 ADELL ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76108-2306
Mailing Address - Country:US
Mailing Address - Phone:817-269-8051
Mailing Address - Fax:
Practice Address - Street 1:319 ADELL ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-2306
Practice Address - Country:US
Practice Address - Phone:817-269-8051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT043212225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist