Provider Demographics
NPI:1023599115
Name:CRUDUP, ANNA
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:CRUDUP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:CROWDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:119 CALLIBLUFF DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-0411
Mailing Address - Country:US
Mailing Address - Phone:843-834-4502
Mailing Address - Fax:888-797-2778
Practice Address - Street 1:119 CALLIBLUFF DR
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-0411
Practice Address - Country:US
Practice Address - Phone:843-834-4502
Practice Address - Fax:888-797-2778
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist