Provider Demographics
NPI:1043476880
Name:TAYLOR, CHRISTINA SUE (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:SUE
Last Name:TAYLOR
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 1:3500 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804-1732
Mailing Address - Country:US
Mailing Address - Phone:812-238-6986
Mailing Address - Fax:
Practice Address - Street 1:3500 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-1732
Practice Address - Country:US
Practice Address - Phone:812-238-6986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003188A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist