Provider Demographics
NPI:1598879926
Name:BERETTA, CHRISTEL (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTEL
Middle Name:
Last Name:BERETTA
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2540 SUNDANCE LN
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-5210
Mailing Address - Country:US
Mailing Address - Phone:517-337-8638
Mailing Address - Fax:
Practice Address - Street 1:3530 E HIAWATHA DR
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-4041
Practice Address - Country:US
Practice Address - Phone:517-372-2700
Practice Address - Fax:517-349-4298
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist