Provider Demographics
NPI:1598808149
Name:BOND-EAVES, CHRISTINE M (MA CCCA A)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:M
Last Name:BOND-EAVES
Suffix:
Gender:F
Credentials:MA CCCA A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MAIN ST
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155
Mailing Address - Country:US
Mailing Address - Phone:781-874-1968
Mailing Address - Fax:781-874-1967
Practice Address - Street 1:101 MAIN STREET
Practice Address - Street 2:SUITE 211
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155
Practice Address - Country:US
Practice Address - Phone:781-874-1968
Practice Address - Fax:781-874-1967
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA317231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5102405Medicaid