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General NPI Number Information
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NPI Number | 1487587812
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Entity Type | Individual
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Provider Name | CRYSTAL OWEN
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Gender | Female
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Dates
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Enumeration Date | 06/05/2026
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Last Update Date | 06/05/2026
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Provider Practice Location Address
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Address Line | 225 ROSENWALD LN
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City | BREVARD
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State | NC
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Zip | 28712-5211
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Country | US
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Telephone | 828-884-6173
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Fax |
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Provider Business Mailing Address
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Address Line | 686 BREEDLOVE RD
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City | LAKE TOXAWAY
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State | NC
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Zip | 28747-8687
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Country | US
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Telephone | 828-553-4409
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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 | 12703
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License Number State | NC
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