Provider Demographics
NPI:1003063850
Name:CROFTON, BETTY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:
Last Name:CROFTON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25315 WINGFIELD LN
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77373-8010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:230 SPRING HILL DR
Practice Address - Street 2:SUITE 305
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-2381
Practice Address - Country:US
Practice Address - Phone:832-797-7099
Practice Address - Fax:281-651-5990
Is Sole Proprietor?:No
Enumeration Date:2008-08-24
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100007235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist