Healthcare Provider Details

I. General information

NPI: 1043144280
Provider Name (Legal Business Name): EMERSON KATHLEEN CRAWFORD AUD-CCC.A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36474C EMERALD COAST PKWY
DESTIN FL
32541-6700
US

IV. Provider business mailing address

20 W BLUE CORAL DR
SANTA ROSA BEACH FL
32459-4550
US

V. Phone/Fax

Practice location:
  • Phone: 833-354-1492
  • Fax:
Mailing address:
  • Phone: 615-974-3669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY3009
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: