Provider Demographics
NPI:1104440114
Name:CRAWFORD, TORIANNA JOVELLE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:TORIANNA
Middle Name:JOVELLE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18649 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-5547
Mailing Address - Country:US
Mailing Address - Phone:708-829-6187
Mailing Address - Fax:
Practice Address - Street 1:18649 WILLOW AVE
Practice Address - Street 2:
Practice Address - City:COUNTRY CLUB HILLS
Practice Address - State:IL
Practice Address - Zip Code:60478-5547
Practice Address - Country:US
Practice Address - Phone:708-829-6187
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-04
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.015272235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist