Provider Demographics
NPI:1679986707
Name:ROGGIE, CHRISTA (MS)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:ROGGIE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 WASHINGTON ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-3372
Mailing Address - Country:US
Mailing Address - Phone:315-786-7202
Mailing Address - Fax:315-786-1524
Practice Address - Street 1:120 WASHINGTON ST
Practice Address - Street 2:SUITE 306
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-3372
Practice Address - Country:US
Practice Address - Phone:315-786-7202
Practice Address - Fax:315-786-1524
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist