Provider Demographics
NPI:1538415393
Name:LOYNES, CRYSTAL M (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:M
Last Name:LOYNES
Suffix:
Gender:F
Credentials:MA, CCC-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 2068
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-8002
Mailing Address - Country:US
Mailing Address - Phone:803-420-0434
Mailing Address - Fax:803-432-7680
Practice Address - Street 1:111 LOY RD
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-8144
Practice Address - Country:US
Practice Address - Phone:803-420-0434
Practice Address - Fax:803-432-7680
Is Sole Proprietor?:No
Enumeration Date:2012-07-31
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4265235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist