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General NPI Number Information
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NPI Number | 1346456068
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Entity Type | Individual
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Provider Name | VIRGINIA ALBERTA CROFT SLP
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 506 W LINCOLN AVE
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City | CHARLESTON
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State | IL
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Zip | 61920-2453
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Country | US
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Telephone | 217-348-3891
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Fax |
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Provider Business Mailing Address
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Address Line | 702 FRONT ST
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City | GAYS
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State | IL
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Zip | 61928-9771
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Country | US
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Telephone | 217-752-6249
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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 | 146000746
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License Number State | IL
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