Provider Demographics
NPI:1104250240
Name:CRAWFORD, KRISTIN DEON (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:DEON
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MRS
Other - First Name:KRISTIN
Other - Middle Name:DEON
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:610 NW 178TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-4254
Mailing Address - Country:US
Mailing Address - Phone:405-708-8892
Mailing Address - Fax:405-330-0167
Practice Address - Street 1:610 NW 178TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-4254
Practice Address - Country:US
Practice Address - Phone:405-708-8892
Practice Address - Fax:405-330-0167
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3438235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist