Provider Demographics
NPI:1942780333
Name:CHRYSTAL CLEAR COMMUNICATION, INC
Entity Type:Organization
Organization Name:CHRYSTAL CLEAR COMMUNICATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRYSTAL
Authorized Official - Middle Name:K
Authorized Official - Last Name:BHOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:305-527-9532
Mailing Address - Street 1:100 NW 108TH TER APT 208
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4088
Mailing Address - Country:US
Mailing Address - Phone:305-527-9532
Mailing Address - Fax:
Practice Address - Street 1:100 NW 108TH TER APT 208
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-4088
Practice Address - Country:US
Practice Address - Phone:305-527-9532
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-15
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty