Provider Demographics
NPI:1043545916
Name:MAGRO, CHRISTY KEE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:KEE
Last Name:MAGRO
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 1:1047 BONNIE LN
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-6333
Mailing Address - Country:US
Mailing Address - Phone:337-277-9276
Mailing Address - Fax:
Practice Address - Street 1:1047 BONNIE LN
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-6333
Practice Address - Country:US
Practice Address - Phone:337-277-9276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2009-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1863235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist