Crystal J Edwards

Individual provider Active NPI Speech-Language Pathologist · Many, LA

NPI 1639633134 · NPPES record last updated Jan 29, 2019

Key facts

NPI
1639633134
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
110693 (TX)
Practice address
965 Fisher Rd
Many, LA 71449-3819
Phone
(337) 499-6650
NPI assigned
Jan 29, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
110693TXMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 110693 TX Yes

Addresses

Primary practice location

965 Fisher Rd
Many, LA 71449-3819

Mailing address

PO Box 311
Many, LA 71449-0311

Other providers in Many, LA

All providers in Many, LA · Speech-Language Pathologist in Louisiana

Sources for this page

Verify at the official NPI Registry.