Provider Demographics
NPI:1306969746
Name:CREWS, MICHAEL FLEMING (M A CCC-SLP A)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:FLEMING
Last Name:CREWS
Suffix:
Gender:F
Credentials:M A CCC-SLP A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 SW HIGGINS AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-3600
Mailing Address - Country:US
Mailing Address - Phone:406-240-6185
Mailing Address - Fax:866-431-9397
Practice Address - Street 1:901 SW HIGGINS AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-3600
Practice Address - Country:US
Practice Address - Phone:406-240-6185
Practice Address - Fax:866-431-9397
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT715235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0535398Medicaid
MT000066455OtherBLUE CROSS BLUE SHIELD