Provider Demographics
NPI:1255669479
Name:CHRISTODOULOU, CATHY COOK (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CATHY
Middle Name:COOK
Last Name:CHRISTODOULOU
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 1:224 SUKOSHI DR
Mailing Address - Street 2:
Mailing Address - City:CALLAWAY
Mailing Address - State:FL
Mailing Address - Zip Code:32404-7710
Mailing Address - Country:US
Mailing Address - Phone:850-871-6060
Mailing Address - Fax:850-871-6060
Practice Address - Street 1:224 SUKOSHI DR
Practice Address - Street 2:
Practice Address - City:CALLAWAY
Practice Address - State:FL
Practice Address - Zip Code:32404-7710
Practice Address - Country:US
Practice Address - Phone:850-871-6060
Practice Address - Fax:850-871-6060
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-29
Last Update Date:2009-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA0002394235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist