Provider Demographics
NPI:1437415619
Name:CREECH, ALETA JOY (SLP-CFY)
Entity Type:Individual
Prefix:
First Name:ALETA
Middle Name:JOY
Last Name:CREECH
Suffix:
Gender:F
Credentials:SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 N COLLINS BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3564
Mailing Address - Country:US
Mailing Address - Phone:469-385-4900
Mailing Address - Fax:469-985-2982
Practice Address - Street 1:1701 N COLLINS BLVD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3564
Practice Address - Country:US
Practice Address - Phone:469-385-4900
Practice Address - Fax:469-385-2982
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX107379235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist