Provider Demographics
NPI:1447653035
Name:CRAWFORD, CHRISTINE KELLY
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:KELLY
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 1:226 WESTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06062-2517
Mailing Address - Country:US
Mailing Address - Phone:860-726-6497
Mailing Address - Fax:
Practice Address - Street 1:90 FRANKLIN SQ
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-2607
Practice Address - Country:US
Practice Address - Phone:860-225-3561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-26
Last Update Date:2014-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker