Provider Demographics
NPI:1679357271
Name:SKRTICH, CELINA MAY
Entity Type:Individual
Prefix:MRS
First Name:CELINA
Middle Name:MAY
Last Name:SKRTICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CELINA
Other - Middle Name:MAY
Other - Last Name:KROPUSHEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11183 US 70 BUS HWY W
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-2364
Mailing Address - Country:US
Mailing Address - Phone:919-243-2201
Mailing Address - Fax:
Practice Address - Street 1:11183 US 70 BUS HWY W
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2364
Practice Address - Country:US
Practice Address - Phone:919-243-2201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30002595235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist