Provider Demographics
NPI:1235209545
Name:STYLE, CHRISTINE J (SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:J
Last Name:STYLE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 EDGEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-3873
Mailing Address - Country:US
Mailing Address - Phone:443-465-4212
Mailing Address - Fax:
Practice Address - Street 1:2920 FEE FEE RD
Practice Address - Street 2:
Practice Address - City:MARYLAND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63043-1915
Practice Address - Country:US
Practice Address - Phone:314-291-0121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006018988235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist