Provider Demographics
NPI:1053858324
Name:CROWSON, KACIE DAUN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KACIE
Middle Name:DAUN
Last Name:CROWSON
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 1:130 BRIARWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75482-7532
Mailing Address - Country:US
Mailing Address - Phone:903-243-0702
Mailing Address - Fax:
Practice Address - Street 1:110 MAIN ST
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2705
Practice Address - Country:US
Practice Address - Phone:903-243-0702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX104374235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist