Provider Demographics
NPI:1053616979
Name:CRABTREE, MARIA D
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:D
Last Name:CRABTREE
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 1:401 BOGLE ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-3823
Mailing Address - Country:US
Mailing Address - Phone:606-676-0638
Mailing Address - Fax:606-676-0789
Practice Address - Street 1:401 BOGLE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-3823
Practice Address - Country:US
Practice Address - Phone:606-676-0638
Practice Address - Fax:606-676-0789
Is Sole Proprietor?:No
Enumeration Date:2011-01-25
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health