Provider Demographics
NPI:1487395604
Name:CRUMBAKER, KELI J
Entity type:Individual
Prefix:MS
First Name:KELI
Middle Name:J
Last Name:CRUMBAKER
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 1:1230 JEWETT DR
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-5906
Mailing Address - Country:US
Mailing Address - Phone:740-617-9549
Mailing Address - Fax:
Practice Address - Street 1:1230 JEWETT DR
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-5906
Practice Address - Country:US
Practice Address - Phone:740-617-9549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-03
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker