Individual
CRYSTAL LOUISE DIFFEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
951 W COLLEGE ST, TROY, MO 63379-1112
(636) 462-6098
Mailing address
5601 HIGHWAY N, ROBERTSVILLE, MO 63072-2662
(314) 609-0912
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2013031749
MO
235Z00000X
Speech-Language Pathologist
Primary
2014029351
MO
Other
Enumeration date
06/09/2014
Last updated
08/18/2014
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