Provider Demographics
NPI:1851473565
Name:CROTSER, DEBORAH KAY (SLP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KAY
Last Name:CROTSER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 W JEFFERSON ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62702-3694
Mailing Address - Country:US
Mailing Address - Phone:217-726-8502
Mailing Address - Fax:217-726-8568
Practice Address - Street 1:1200 W JEFFERSON ST
Practice Address - Street 2:SUITE D
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62702-3694
Practice Address - Country:US
Practice Address - Phone:217-726-8502
Practice Address - Fax:217-726-8568
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist