Provider Demographics
NPI:1598916736
Name:DOWNS, CRYSTAL YVONNE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:YVONNE
Last Name:DOWNS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 CONGRESS PKWY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-4577
Mailing Address - Country:US
Mailing Address - Phone:404-493-6710
Mailing Address - Fax:
Practice Address - Street 1:3756 LAVISTA RD
Practice Address - Street 2:SUITE 104
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-5614
Practice Address - Country:US
Practice Address - Phone:404-477-9400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006768235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist