Provider Demographics
NPI:1891794632
Name:CROSSROADS SPEECH & HEARING, INC.
Entity Type:Organization
Organization Name:CROSSROADS SPEECH & HEARING, INC.
Other - Org Name:CROSSROADS SPEECH & HEARING, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTIE-ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CONRAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-941-4434
Mailing Address - Street 1:3240 WASHINGTON RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3180
Mailing Address - Country:US
Mailing Address - Phone:724-941-4434
Mailing Address - Fax:724-941-4714
Practice Address - Street 1:3240 WASHINGTON RD
Practice Address - Street 2:SUITE 200
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3180
Practice Address - Country:US
Practice Address - Phone:724-941-4434
Practice Address - Fax:724-941-4714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1000033000005Medicare ID - Type UnspecifiedSPEECH THERAPY