Organization
KRYSTAL KLEAR SPEECH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL GAMBRELL (OWNER/CEO)
(404) 520-0087
Entity
Organization
Contact information
Practice address
4075 DEMOONEY RD, COLLEGE PARK, GA 30349-1312
(404) 520-0087
Mailing address
4075 DEMOONEY RD, COLLEGE PARK, GA 30349-1312
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629370853
—
GA
Enumeration date
11/19/2019
Last updated
12/21/2020
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