Provider Demographics
NPI:1528731676
Name:DOLAN DELGADO, CRYSTAL M
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:M
Last Name:DOLAN DELGADO
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 1:921 W SANGER ST
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-4917
Mailing Address - Country:US
Mailing Address - Phone:575-433-2002
Mailing Address - Fax:888-729-4956
Practice Address - Street 1:921 W SANGER ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-4917
Practice Address - Country:US
Practice Address - Phone:575-433-2002
Practice Address - Fax:888-729-4956
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX41695OtherTEXAS SLPA LICENSE