Provider Demographics
NPI:1528192101
Name:CROWLEY, ALBERT B (MS, CCC-S,A)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:B
Last Name:CROWLEY
Suffix:
Gender:M
Credentials:MS, CCC-S,A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 NW 19TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-3527
Mailing Address - Country:US
Mailing Address - Phone:352-371-3680
Mailing Address - Fax:352-372-5317
Practice Address - Street 1:4125 NW 19TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3527
Practice Address - Country:US
Practice Address - Phone:352-371-3680
Practice Address - Fax:352-372-5317
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY 500231H00000X
FLSA 2733235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist