Provider Demographics
NPI:1295026656
Name:DASILVA FREITAS, CHRISTIANA RUTH (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:RUTH
Last Name:DASILVA FREITAS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:CHRISTIANA
Other - Middle Name:RUTH
Other - Last Name:LUNDQUIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CFY-SLP
Mailing Address - Street 1:160 NW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-3826
Mailing Address - Country:US
Mailing Address - Phone:561-391-8444
Mailing Address - Fax:
Practice Address - Street 1:5980 RADIO STATION RD
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-3337
Practice Address - Country:US
Practice Address - Phone:301-932-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD235Z00000X
FLSZ5239235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist