Provider Demographics
NPI:1609517085
Name:CRABTREE-DAVISON, MARNI LEE (MACMHC)
Entity type:Individual
Prefix:MS
First Name:MARNI
Middle Name:LEE
Last Name:CRABTREE-DAVISON
Suffix:
Gender:F
Credentials:MACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7037 CAMELOT CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-3649
Mailing Address - Country:US
Mailing Address - Phone:317-400-5140
Mailing Address - Fax:
Practice Address - Street 1:1928 S DAN JONES RD
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:IN
Practice Address - Zip Code:46123-6678
Practice Address - Country:US
Practice Address - Phone:317-854-8265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2024-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN101YM0800X
IN88001763A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health