Provider Demographics
NPI:1275612129
Name:NORTON, CRYSTAL BREVARD (MA)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:BREVARD
Last Name:NORTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:CRYSTAL
Other - Middle Name:LEE
Other - Last Name:BREVARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2320 CHANTILLY CT
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-7137
Mailing Address - Country:US
Mailing Address - Phone:704-935-4727
Mailing Address - Fax:
Practice Address - Street 1:2320 CHANTILLY CT
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28081-7137
Practice Address - Country:US
Practice Address - Phone:704-935-4727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5451235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist