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NPI Code Detail

MEDICARE: MRS. JEAN KATHERINE CROWDER MS,CCC-SLP

MEDICARE: MRS. JEAN KATHERINE CROWDER MS,CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSA6323FL

General Provider Information

NPI Number : 1780773713
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JEAN KATHERINE CROWDER MS,CCC-SLP
Provider Business Mailing Address
First Line : 7103 SCENIC HWY
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-6831
Country : US
Telephone Number : 850-434-7755
Fax Number : 850-469-0858
Provider Business Practice Location Address
First Line : 3916 N 10TH AVE
Second Line :
City : PENSACOLA
State : FL
Zip : 32503-2807
Country : US
Telephone Number : 850-434-7755
Fax Number : 850-469-0858
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. JEAN KATHERINE CROWDER MS,CCC-SLP” Practice Location

Language Start Address Practice Location
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