Provider Demographics
NPI:1386758381
Name:DOVER, CRYSTAL KAY (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:KAY
Last Name:DOVER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 ROTUNDA CIR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-0009
Mailing Address - Country:US
Mailing Address - Phone:828-259-9649
Mailing Address - Fax:828-254-8887
Practice Address - Street 1:143 MERRIMON AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-1815
Practice Address - Country:US
Practice Address - Phone:828-254-8889
Practice Address - Fax:828-254-8887
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC527235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7401091Medicaid
NC185278OtherMEDCOST
NC141PGOtherBCBSNC