Provider Demographics
NPI:1134318744
Name:CRUTCHLEY, SENA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SENA
Middle Name:
Last Name:CRUTCHLEY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNS SUMMIT
Mailing Address - State:NC
Mailing Address - Zip Code:27214-9704
Mailing Address - Country:US
Mailing Address - Phone:336-217-5124
Mailing Address - Fax:336-217-5127
Practice Address - Street 1:5900 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:BROWNS SUMMIT
Practice Address - State:NC
Practice Address - Zip Code:27214-9704
Practice Address - Country:US
Practice Address - Phone:336-217-5124
Practice Address - Fax:336-217-5127
Is Sole Proprietor?:No
Enumeration Date:2007-10-19
Last Update Date:2008-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5256235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist