Provider Demographics
NPI:1114170016
Name:CROSSWAIT-DEGEN, E. ANNE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:E.
Middle Name:ANNE
Last Name:CROSSWAIT-DEGEN
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 1:1430 W CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:SPEARFISH
Mailing Address - State:SD
Mailing Address - Zip Code:57783-1661
Mailing Address - Country:US
Mailing Address - Phone:605-642-7476
Mailing Address - Fax:
Practice Address - Street 1:1430 W CHARLES ST
Practice Address - Street 2:
Practice Address - City:SPEARFISH
Practice Address - State:SD
Practice Address - Zip Code:57783-1661
Practice Address - Country:US
Practice Address - Phone:605-642-7476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist