Individual
AMANDA CRISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-5820
(580) 379-5829
Mailing address
1200 E PECAN ST, ALTUS, OK 73521-6141
(580) 379-5820
(580) 379-5829
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3044
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201089850A
—
OK
Enumeration date
11/12/2014
Last updated
11/21/2023
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