| Doctor Name: | MRS. CRYSTAL MOORE KOPPAL |
| NPI Number: | 1619185048 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CCC-SLP |
| License Number: | SA8120 |
| Business Practice Address: | 1034 Nw 57th St Suite C Gainesville, FL - 326056452 |
| Business Phone Number: | 3523329015 |
| Business Fax Number: | 3523329941 |
| Mailing Address: | 305 Nw 28th St, GAINESVILLE |
| State: | FL |
| Postal Code: | 326072565 |
| Phone Number: | 3523711865 |
| Fax Number: | 3523329941 |
| NPI Enumeration Date: | 05/18/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA8120 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |