Provider Demographics
NPI:1053026864
Name:CROWDER, KYNDAL NICOLE (SLP)
Entity type:Individual
Prefix:
First Name:KYNDAL
Middle Name:NICOLE
Last Name:CROWDER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KYNDAL
Other - Middle Name:NICOLE
Other - Last Name:CROWDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 N AVENUE G STE B
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:TX
Mailing Address - Zip Code:76634-1524
Mailing Address - Country:US
Mailing Address - Phone:817-223-0625
Mailing Address - Fax:
Practice Address - Street 1:100 N AVENUE G STE B
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TX
Practice Address - Zip Code:76634-1524
Practice Address - Country:US
Practice Address - Phone:817-223-0625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-16
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist