Provider Demographics
NPI:1164892527
Name:BINFORD, CHRISTY CORNELL (MA-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:CORNELL
Last Name:BINFORD
Suffix:
Gender:F
Credentials:MA-SLP
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:CORNELL
Other - Last Name:INGRAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA-SLP
Mailing Address - Street 1:7353 SCOTTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-3130
Mailing Address - Country:US
Mailing Address - Phone:513-608-3593
Mailing Address - Fax:
Practice Address - Street 1:2411 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45225-1001
Practice Address - Country:US
Practice Address - Phone:513-363-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.7063235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01311958Medicaid