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General NPI Number Information
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NPI Number | 1306651286
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Entity Type | Individual
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Provider Name | BENNETT CRAWFORD CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/10/2025
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 26850 S BAY DR
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-4379
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Country | US
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Telephone | 239-948-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 20635 LARINO LOOP
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City | ESTERO
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State | FL
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Zip | 33928-6375
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Country | US
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Telephone | 239-699-8444
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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 | SA21034
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License Number State | FL
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