Organization
SPEECH OUT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LULILA CRAWFORD M.S., CCC-SLP (SPEECH PATHOLOGIST)
(478) 955-5826
Entity
Organization
Contact information
Practice address
507 NORTH DAVIS DRIVE SECOND FLOOR, WARNER ROBINS, GA 31093
(478) 955-5826
Mailing address
202 N DAVIS DR STE 265, WARNER ROBINS, GA 31093-3348
(478) 955-5826
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006295
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
860705211G
—
GA
Enumeration date
06/15/2012
Last updated
06/15/2012
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