Dominique Suzanne Crawford
Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children in Martinez, CA. Individual provider (NPI-1).
NPI number1982807665
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1982807665
- Entity type
- Individual (NPI-1)
- Name
- Dominique Suzanne Crawford
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 8, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3245S0500X | Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | 070012bn | CA | Yes |
Practice location
4645 Pacheco BlvdMartinez, CA 94553-3625
Phone 925-646-9270 · Fax 925-646-9276
Mailing address
Po Box 1109Martinez, CA 94553-0110
Phone 925-646-9270 · Fax 925-646-9276
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