Provider Demographics
NPI:1689706954
Name:CROWE, MARTHA GEDELLE SAPOUGH (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA GEDELLE
Middle Name:SAPOUGH
Last Name:CROWE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:MARTHA
Other - Middle Name:GEDELLE
Other - Last Name:SAPOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:152 GRAY MANS LOOP
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-6634
Mailing Address - Country:US
Mailing Address - Phone:843-237-2172
Mailing Address - Fax:
Practice Address - Street 1:38 LAKES AT LITCHFIELD DR
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-5768
Practice Address - Country:US
Practice Address - Phone:843-237-0343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3341235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist