Provider Demographics
NPI:1699051334
Name:CRAWFORD, NANCY ELIZABETH (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ELIZABETH
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 ERIE BLVD W
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2749
Mailing Address - Country:US
Mailing Address - Phone:315-435-4202
Mailing Address - Fax:315-435-4987
Practice Address - Street 1:1025 ERIE BLVD W
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-2749
Practice Address - Country:US
Practice Address - Phone:315-435-4202
Practice Address - Fax:315-435-4987
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006891235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist