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NPI 1144835992

NPI 1144835992 : JESSICA CRAWFORD SLP : CLARKSVILLE, OH

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General NPI Number Information
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    NPI Number           |    1144835992
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    Entity Type          |    Individual 
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    Provider Name        |    JESSICA CRAWFORD SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/09/2020
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    Last Update Date     |    09/14/2020
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Provider Practice Location Address
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    Address Line         |    2380 LEBANON RD 
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    City                 |    CLARKSVILLE
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    State                |    OH
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    Zip                  |    45113-8326
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    Country              |    US
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    Telephone            |    937-289-2515
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2380 LEBANON RD 
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    City                 |    CLARKSVILLE
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    State                |    OH
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    Zip                  |    45113-8326
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    Country              |    US
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    Telephone            |    937-289-2515
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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       |    
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    License Number State |    
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