Provider Demographics
NPI:1295973618
Name:CROUSE, MICHAEL W (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:W
Last Name:CROUSE
Suffix:
Gender:M
Credentials:AUD, CCC-A
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 8469
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-8469
Mailing Address - Country:US
Mailing Address - Phone:706-327-8459
Mailing Address - Fax:706-327-0860
Practice Address - Street 1:4919 CARMICHAEL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2917
Practice Address - Country:US
Practice Address - Phone:334-239-7877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1014A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist