Provider Demographics
NPI:1306001565
Name:HORTON, CHRISTINA COBB (MSP, SLP-CCC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:COBB
Last Name:HORTON
Suffix:
Gender:F
Credentials:MSP, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 STONEWALL CT
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-8931
Mailing Address - Country:US
Mailing Address - Phone:803-781-5039
Mailing Address - Fax:
Practice Address - Street 1:28 KITFOX CT
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-7324
Practice Address - Country:US
Practice Address - Phone:803-732-4175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-26
Last Update Date:2008-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist