Provider Demographics
NPI:1245041284
Name:CRUMP, MADISON
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:CRUMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7020 ROLLINGGREEN DR
Mailing Address - Street 2:
Mailing Address - City:PASS CHRISTIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39571-8149
Mailing Address - Country:US
Mailing Address - Phone:228-216-0827
Mailing Address - Fax:
Practice Address - Street 1:7020 ROLLINGGREEN DR
Practice Address - Street 2:
Practice Address - City:PASS CHRISTIAN
Practice Address - State:MS
Practice Address - Zip Code:39571-8149
Practice Address - Country:US
Practice Address - Phone:228-216-0827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist