Provider Demographics
NPI:1154830958
Name:CROSBY, CHRISTA ANDRA (MA, SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:ANDRA
Last Name:CROSBY
Suffix:
Gender:F
Credentials:MA, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 S 1ST AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2162
Mailing Address - Country:US
Mailing Address - Phone:973-953-1381
Mailing Address - Fax:
Practice Address - Street 1:515 S 1ST AVE APT 12
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2162
Practice Address - Country:US
Practice Address - Phone:973-953-1381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00918000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist