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Individual
MS. CHANNING HEAVENOR CREVELING
Active
Individual
MS. CHANNING HEAVENOR CREVELING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP LLC
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
6881
NC
235Z00000X
Speech-Language Pathologist
Primary
SA12781
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104167600
—
FL
05
—
7412500
—
NC
Enumeration date
07/19/2006
Last updated
10/10/2020
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