Provider Demographics
NPI:1447564075
Name:GRAFTON, CRYSTAL LYNNE (MS, CCC/SLP)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LYNNE
Last Name:GRAFTON
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1915 WELBY WAY
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4594
Mailing Address - Country:US
Mailing Address - Phone:850-325-6301
Mailing Address - Fax:850-325-6302
Practice Address - Street 1:1915 WELBY WAY
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4594
Practice Address - Country:US
Practice Address - Phone:850-325-6301
Practice Address - Fax:850-325-6302
Is Sole Proprietor?:No
Enumeration Date:2010-08-06
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 10570235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist