Provider Demographics
NPI:1447797543
Name:NORDELL, CHRISTINE L (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:L
Last Name:NORDELL
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11671 OAKVIEW CT
Mailing Address - Street 2:
Mailing Address - City:CHAMPLIN
Mailing Address - State:MN
Mailing Address - Zip Code:55316-2624
Mailing Address - Country:US
Mailing Address - Phone:763-458-4381
Mailing Address - Fax:
Practice Address - Street 1:11671 OAKVIEW CT
Practice Address - Street 2:
Practice Address - City:CHAMPLIN
Practice Address - State:MN
Practice Address - Zip Code:55316-2624
Practice Address - Country:US
Practice Address - Phone:763-732-1470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-26
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5527235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist