Provider Demographics
NPI:1164978607
Name:SOMERVILLE, CHRISTINA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:SOMERVILLE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-1349
Mailing Address - Country:US
Mailing Address - Phone:740-283-3347
Mailing Address - Fax:740-283-2709
Practice Address - Street 1:2023 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-1349
Practice Address - Country:US
Practice Address - Phone:740-283-3347
Practice Address - Fax:740-283-2709
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.6264235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist