Healthcare Provider Details

I. General information

NPI: 1497670665
Provider Name (Legal Business Name): RACHEL ELIZABETH CRAZYBEAR M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 S GRAY AVE
JOPLIN MO
64801-2945
US

IV. Provider business mailing address

436 PENNSYLVANIA AVE
JASPER MO
64755-9278
US

V. Phone/Fax

Practice location:
  • Phone: 417-625-5270
  • Fax:
Mailing address:
  • Phone: 417-214-6333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2026026724
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: