Provider Demographics
NPI:1093049074
Name:O'CONNOR, CHRISTINE FRANCES (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:FRANCES
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:127 LUBRANO DR STE L1
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7322
Mailing Address - Country:US
Mailing Address - Phone:410-573-1064
Mailing Address - Fax:
Practice Address - Street 1:127 LUBRANO DR STE L1
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7322
Practice Address - Country:US
Practice Address - Phone:410-573-1064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD662901235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist