Provider Demographics
NPI:1346572310
Name:BARBEAU, CHRISTIE LAURA
Entity Type:Individual
Prefix:MISS
First Name:CHRISTIE
Middle Name:LAURA
Last Name:BARBEAU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 W MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-2158
Mailing Address - Country:US
Mailing Address - Phone:602-347-4850
Mailing Address - Fax:
Practice Address - Street 1:1502 W MOUNTAIN VIEW RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-2158
Practice Address - Country:US
Practice Address - Phone:602-347-4850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA62902355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant