Provider Demographics
NPI:1003119306
Name:CRUVANT, ALISON HEATHER (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:HEATHER
Last Name:CRUVANT
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 1:113 GRACE ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-3905
Mailing Address - Country:US
Mailing Address - Phone:917-589-1884
Mailing Address - Fax:
Practice Address - Street 1:113 GRACE ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-3905
Practice Address - Country:US
Practice Address - Phone:917-589-1884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015518-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist