Provider Demographics
NPI:1437886108
Name:CRAWFORD, CAROL (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:THEOBALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:5910 CALICO CROSSING LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-3516
Mailing Address - Country:US
Mailing Address - Phone:713-392-3747
Mailing Address - Fax:
Practice Address - Street 1:26622 COOK FIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2139
Practice Address - Country:US
Practice Address - Phone:281-766-3831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106091235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist