Provider Demographics
NPI:1396467221
Name:WHITE, CRYSTAL ELIZABETH (SLPA)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:ELIZABETH
Last Name:WHITE
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67712 RING NECK DOVE DR
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-6376
Mailing Address - Country:US
Mailing Address - Phone:504-616-7279
Mailing Address - Fax:
Practice Address - Street 1:3059 HIGGINS BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-5422
Practice Address - Country:US
Practice Address - Phone:504-308-3660
Practice Address - Fax:504-754-7980
Is Sole Proprietor?:No
Enumeration Date:2022-09-16
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA60012355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant