Provider Demographics
NPI:1750367900
Name:CROWLEY, GRETT DONEEN (MS, CCC-SP/A)
Entity type:Individual
Prefix:MRS
First Name:GRETT
Middle Name:DONEEN
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:MS, CCC-SP/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28850 HIGHWAY 98
Mailing Address - Street 2:STE. 104
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-7257
Mailing Address - Country:US
Mailing Address - Phone:251-621-1660
Mailing Address - Fax:251-621-1660
Practice Address - Street 1:28850 HIGHWAY 98
Practice Address - Street 2:STE. 104
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-7257
Practice Address - Country:US
Practice Address - Phone:251-621-1660
Practice Address - Fax:251-621-1660
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL707A231H00000X, 231HA2400X, 237600000X
AL1086235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL510-42911Medicaid
AL510-42911Medicaid