Provider Demographics
NPI:1346050614
Name:CRAWFORD, ALEXIS ARIANA
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:ARIANA
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 1:6708 BRADFORD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-3313
Mailing Address - Country:US
Mailing Address - Phone:706-405-0178
Mailing Address - Fax:
Practice Address - Street 1:7330 LYNCH RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:GA
Practice Address - Zip Code:31820-4010
Practice Address - Country:US
Practice Address - Phone:912-385-4648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GABACB1142399106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician