Provider Demographics
NPI:1942207808
Name:CAUSER, CRYSTAL KAYE (AUD)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:KAYE
Last Name:CAUSER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:KAYE
Other - Last Name:DEACON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:501 HOWARD AVE
Mailing Address - Street 2:D-203
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601
Mailing Address - Country:US
Mailing Address - Phone:814-946-0721
Mailing Address - Fax:814-946-0783
Practice Address - Street 1:501 HOWARD AVE
Practice Address - Street 2:D-203
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601
Practice Address - Country:US
Practice Address - Phone:814-946-0721
Practice Address - Fax:814-946-0783
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000900L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADE234771OtherBLUE CROSS
PA0018635550004Medicaid
PA0018635550001Medicaid
PA048606Medicare ID - Type Unspecified
PA0018635550001Medicaid