Provider Demographics
NPI:1295918852
Name:CRAWFORD, RENEE CYNTHIA-LAUDERDALE (MSW)
Entity type:Individual
Prefix:MS
First Name:RENEE
Middle Name:CYNTHIA-LAUDERDALE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 SCENIC DRIVE
Mailing Address - Street 2:BLDG 3
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95353-3127
Mailing Address - Country:US
Mailing Address - Phone:209-558-7363
Mailing Address - Fax:209-558-8315
Practice Address - Street 1:830 SCENIC DRIVE
Practice Address - Street 2:BLDG 3
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95353-3127
Practice Address - Country:US
Practice Address - Phone:209-558-7363
Practice Address - Fax:209-558-8315
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator