Individual
MRS. CRYSTAL M MCKOIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPEECH
Contact information
Practice address
3867 BAYOU ACRES DR, BASTROP, LA 71220-9232
(318) 283-2080
(318) 283-0606
Mailing address
10578 CAMELIA AVE, BASTROP, LA 71220-2502
(318) 283-2080
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5618
LA
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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