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General NPI Number Information
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NPI Number | 1033625298
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Entity Type | Individual
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Provider Name | KAITLYN MELISSA CRAWFORD MA CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 12/22/2017
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Last Update Date | 07/01/2020
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Provider Practice Location Address
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Address Line | 1844 W 38TH PL
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City | LOS ANGELES
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State | CA
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Zip | 90062-1009
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Country | US
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Telephone | 424-261-5127
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Fax |
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Provider Business Mailing Address
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Address Line | 1844 W 38TH PL
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City | LOS ANGELES
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State | CA
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Zip | 90062-1009
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Country | US
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Telephone | 424-261-5127
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 25607
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License Number State | CA
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