Provider Demographics
NPI:1699491951
Name:CRAWFORD, ROXANNE COLLETTE (MEDICAL ASSISTANT)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:COLLETTE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:COLLETTE
Other - Last Name:DEBOZY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:9020 FOWLER RD
Mailing Address - Street 2:
Mailing Address - City:HORTON
Mailing Address - State:MI
Mailing Address - Zip Code:49246-9530
Mailing Address - Country:US
Mailing Address - Phone:734-645-0942
Mailing Address - Fax:
Practice Address - Street 1:3200 E EISENHOWER PKWY
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3231
Practice Address - Country:US
Practice Address - Phone:734-677-0070
Practice Address - Fax:734-428-0408
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health