Provider Demographics
NPI:1487392759
Name:CROW, DANA CLIFTON
Entity type:Individual
Prefix:MR
First Name:DANA
Middle Name:CLIFTON
Last Name:CROW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 3RD AVE NW
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74354-5701
Mailing Address - Country:US
Mailing Address - Phone:918-919-2047
Mailing Address - Fax:
Practice Address - Street 1:303 3RD AVE NW
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:OK
Practice Address - Zip Code:74354-5701
Practice Address - Country:US
Practice Address - Phone:918-919-2047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator