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NPI Code Detail

MEDICARE: CRYSTAL DENISE CLARY M.S., CCC-SLP

MEDICARE:   CRYSTAL DENISE CLARY  M.S., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist15330TX

General Provider Information

NPI Number : 1235347345
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRYSTAL DENISE CLARY M.S., CCC-SLP
Provider Business Mailing Address
First Line : 2810 REX ALLEN DR
Second Line :
City : ABILENE
State : TX
Zip : 79606-4340
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2722 OLD ANSON RD
Second Line :
City : ABILENE
State : TX
Zip : 79603-1834
Country : US
Telephone Number : 325-676-1677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2007
Last Update Date : 07/08/2007

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Directions to “ CRYSTAL DENISE CLARY M.S., CCC-SLP” Practice Location

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