Provider Demographics
NPI:1275729485
Name:IRWIN, CHRISTIAN WRENEA (MS)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIAN
Middle Name:WRENEA
Last Name:IRWIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 MOUNTAIN CREEK RD
Mailing Address - Street 2:SUITE 380
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-1687
Mailing Address - Country:US
Mailing Address - Phone:423-877-5042
Mailing Address - Fax:423-877-5046
Practice Address - Street 1:1200 MOUNTAIN CREEK RD
Practice Address - Street 2:SUITE 380
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-1687
Practice Address - Country:US
Practice Address - Phone:423-877-5042
Practice Address - Fax:423-877-5046
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3168235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist