Individual
MS. BETHANY MARIE KISNER-CROSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA-SLP-CCC-L
Contact information
Practice address
247 TILTON PARK DR, DEKALB, IL 60115-1955
(815) 739-1452
(815) 756-5359
Mailing address
247 TILTON PARK DR, DEKALB, IL 60115-1955
(815) 739-1452
(815) 756-5359
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146005808
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01926198
BCBS
IL
Enumeration date
03/04/2007
Last updated
01/28/2015
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