Provider Demographics
NPI:1689008344
Name:CROW, SANDRA ALLISON (MA,CCC-SLP)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:ALLISON
Last Name:CROW
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:ALLISON
Other - Last Name:FREYALDENHOVEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,CCC-SLP
Mailing Address - Street 1:3004 MOORES LN
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-2204
Mailing Address - Country:US
Mailing Address - Phone:903-293-3766
Mailing Address - Fax:
Practice Address - Street 1:3004 MOORES LN
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-2204
Practice Address - Country:US
Practice Address - Phone:903-293-3766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2024-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#3062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist