Provider Demographics
NPI:1902977010
Name:CRUMLEY, JANE (MSCCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:
Last Name:CRUMLEY
Suffix:
Gender:F
Credentials:MSCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 483
Mailing Address - Street 2:SUITE H
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-0483
Mailing Address - Country:US
Mailing Address - Phone:956-440-8658
Mailing Address - Fax:956-440-1412
Practice Address - Street 1:1906 E TYLER AVE
Practice Address - Street 2:SUITE H
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7106
Practice Address - Country:US
Practice Address - Phone:956-440-8658
Practice Address - Fax:956-440-1412
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15050235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136482100OtherVALLEY HEALTHPLAN
TX003552902Medicaid
TX87536TOtherBLUE CROSS BLUE SHIELD