Provider Demographics
NPI:1457755126
Name:CRANE, MAUREEN B (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:B
Last Name:CRANE
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 1:304 ELIZABETH AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-4409
Mailing Address - Country:US
Mailing Address - Phone:908-421-1464
Mailing Address - Fax:
Practice Address - Street 1:30 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3253
Practice Address - Country:US
Practice Address - Phone:908-421-1464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00237700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist