Provider Demographics
NPI:1346397742
Name:WRIGHT, CRYSTAL D
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:D
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CRYSTAL
Other - Middle Name:D
Other - Last Name:ZAKRAJSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9 ACADEMY ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:13865-4037
Mailing Address - Country:US
Mailing Address - Phone:607-655-5906
Mailing Address - Fax:
Practice Address - Street 1:440 FOLEY RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:13865-1007
Practice Address - Country:US
Practice Address - Phone:607-775-3226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006983235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist