Provider Demographics
NPI:1205382116
Name:CROWLEY, CATHERINE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8417 BLAZING SUN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-2196
Mailing Address - Country:US
Mailing Address - Phone:248-675-9104
Mailing Address - Fax:
Practice Address - Street 1:3985 W CHEYENNE AVE STE 306
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-8907
Practice Address - Country:US
Practice Address - Phone:702-515-4009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-30
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-2515235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist