Provider Demographics
NPI:1467797241
Name:CROUCH, PATRICIA EDDIE (SLP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:EDDIE
Last Name:CROUCH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:EDDIE
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:308 LIBERTY ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-3040
Mailing Address - Country:US
Mailing Address - Phone:541-482-4809
Mailing Address - Fax:
Practice Address - Street 1:308 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-3040
Practice Address - Country:US
Practice Address - Phone:541-482-4809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11158235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist