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Individual

CRYSTAL WARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
122 BOWEN RD, ANDERSON, SC 29621-3608
(864) 642-5793
Mailing address
122 BOWEN RD, ANDERSON, SC 29621-3608
(864) 642-5793

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4213
SC
235Z00000X
Speech-Language Pathologist
SLP006050
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
170721879C
GA
01
4213
SOUTH CAROLINA BOARD OF EXAMINERS IN SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
SC
01
SLP006050
STATE LICENSE
GA
Enumeration date
12/05/2006
Last updated
03/04/2013
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