Provider Demographics
NPI:1316186778
Name:CRUSHA, ANNA VICTORIA LOVE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:VICTORIA LOVE
Last Name:CRUSHA
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 1:7545 NE HIGHWAY 82
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:MO
Mailing Address - Zip Code:64776-2630
Mailing Address - Country:US
Mailing Address - Phone:417-646-2233
Mailing Address - Fax:
Practice Address - Street 1:408 W 4TH ST
Practice Address - Street 2:
Practice Address - City:APPLETON CITY
Practice Address - State:MO
Practice Address - Zip Code:64724-1408
Practice Address - Country:US
Practice Address - Phone:660-476-2108
Practice Address - Fax:660-476-5564
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003009743235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist