Provider Demographics
NPI:1649748542
Name:ONDIAK, CHRISTA CAVALUCHI (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:CAVALUCHI
Last Name:ONDIAK
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 1:2212 BOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-1734
Mailing Address - Country:US
Mailing Address - Phone:571-224-7964
Mailing Address - Fax:
Practice Address - Street 1:2212 BOXWOOD DR
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-1734
Practice Address - Country:US
Practice Address - Phone:571-224-7964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202008160235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist