Provider Demographics
NPI:1659472744
Name:BURNS, CHRISTINA BRUGGEMAR (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:BRUGGEMAR
Last Name:BURNS
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5356 REYNOLDS ST
Mailing Address - Street 2:SUITE 505
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-6016
Mailing Address - Country:US
Mailing Address - Phone:912-303-3560
Mailing Address - Fax:912-303-3506
Practice Address - Street 1:5356 REYNOLDS ST
Practice Address - Street 2:SUITE 505
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6016
Practice Address - Country:US
Practice Address - Phone:912-303-3560
Practice Address - Fax:912-303-3506
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003419231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000831652NMedicaid
GA000831652NMedicaid
P00133750Medicare ID - Type UnspecifiedRAILROAD MEDICARE
SCSAG006Medicaid
GA000831652DMedicaid