Most Relevant Information
Provider Data
| NPI Number: | 1003654195 |
| Provider Name: | SHAWNTAY DORAE CRAWFORD |
| Entity Type: | Individual |
| Taxonomy Code: | 103K00000X |
| Specialty: | Behavior Analyst |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/15/2024 |
| Last Updated: | 07/15/2024 |
Provider Practice Location
215 E 4TH ST
HOISINGTON
KS
675442317
Practice Location Phone/Fax
| Phone: | 6202927168 |
| Fax: |
Provider Mailing Location
971 E WICHITA AVE
RUSSELL
KS
676652444
Provider Mailing Phone/Fax
| Phone: | 7853774744 |
| Fax: |