Provider Demographics
NPI:1619181112
Name:ZITO, CHRISTINE MICHELLE (CCC SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MICHELLE
Last Name:ZITO
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4231 TIMBERGLEN RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-3971
Mailing Address - Country:US
Mailing Address - Phone:469-951-8283
Mailing Address - Fax:
Practice Address - Street 1:2736 TOWNE CENTRE DR STE A
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4184
Practice Address - Country:US
Practice Address - Phone:214-484-4236
Practice Address - Fax:903-525-3855
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101974235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist