Provider Demographics
NPI:1992462592
Name:CROWE, SAVANNA (RBT)
Entity type:Individual
Prefix:MS
First Name:SAVANNA
Middle Name:
Last Name:CROWE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:SAVANNA
Other - Middle Name:C
Other - Last Name:LOGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RBT
Mailing Address - Street 1:107 WEATHERSTONE DR STE 530
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30188-7006
Mailing Address - Country:US
Mailing Address - Phone:770-591-9552
Mailing Address - Fax:800-218-8249
Practice Address - Street 1:107 WEATHERSTONE DR STE 530
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-7006
Practice Address - Country:US
Practice Address - Phone:770-591-9552
Practice Address - Fax:800-218-8249
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-21-151481106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
RBT-21-151481OtherBEHAVIOR ANALYSIS CERTIFICATION BOARD