Provider Demographics
NPI:1376705566
Name:CANIGLIA, CHRISTINE ANN (MS)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANN
Last Name:CANIGLIA
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 1:637 N EWING ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3604
Mailing Address - Country:US
Mailing Address - Phone:406-461-2853
Mailing Address - Fax:
Practice Address - Street 1:637 N EWING ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3604
Practice Address - Country:US
Practice Address - Phone:406-461-2853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-28
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT607235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT533562Medicaid