Provider Demographics
NPI:1356669303
Name:O'DONOVAN, CHRISTI STAR (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:STAR
Last Name:O'DONOVAN
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:CHRISTI
Other - Middle Name:STAR
Other - Last Name:BERGLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 BRADLEY RD
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-4921
Mailing Address - Country:US
Mailing Address - Phone:631-560-9970
Mailing Address - Fax:
Practice Address - Street 1:751 GRANITE ST
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-5328
Practice Address - Country:US
Practice Address - Phone:781-380-4360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist