Provider Demographics
NPI:1356597017
Name:CREWSON, ALIYA MARIE (SLP)
Entity type:Individual
Prefix:
First Name:ALIYA
Middle Name:MARIE
Last Name:CREWSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3478 TIMOTHY LN
Mailing Address - Street 2:
Mailing Address - City:EAST AURORA
Mailing Address - State:NY
Mailing Address - Zip Code:14052-9610
Mailing Address - Country:US
Mailing Address - Phone:716-652-2812
Mailing Address - Fax:
Practice Address - Street 1:1586 EGGERT RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-3361
Practice Address - Country:US
Practice Address - Phone:716-204-5925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58-018150235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist