Provider Demographics
NPI:1386254985
Name:CROWE, CHRISTINA FOUCAULT
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:FOUCAULT
Last Name:CROWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 TEAKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-1329
Mailing Address - Country:US
Mailing Address - Phone:818-516-0223
Mailing Address - Fax:
Practice Address - Street 1:823 TEAKWOOD RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90049-1329
Practice Address - Country:US
Practice Address - Phone:818-516-0223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASA7640235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist