Provider Demographics
NPI:1578126512
Name:MCCAIN, CHRISTINA VEDROS (MCD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:VEDROS
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:VEDROS
Other - Last Name:MCCAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 MADELYN LN
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-8524
Mailing Address - Country:US
Mailing Address - Phone:985-217-4589
Mailing Address - Fax:
Practice Address - Street 1:17 MADELYN LN
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NC
Practice Address - Zip Code:28730-8524
Practice Address - Country:US
Practice Address - Phone:985-217-4589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-16
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7880235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist