Provider Demographics
NPI:1063931400
Name:CRUTCHFIELD-KEEVEN, JULIA E (MHS)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:E
Last Name:CRUTCHFIELD-KEEVEN
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7898 VETERANS MEMORIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-5910
Mailing Address - Country:US
Mailing Address - Phone:636-474-8032
Mailing Address - Fax:
Practice Address - Street 1:7898 VETERANS MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-5910
Practice Address - Country:US
Practice Address - Phone:636-474-8032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004022982235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist