Provider Demographics
NPI:1689183667
Name:BEATTY, CHRISTINA LYNN (MS CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYNN
Last Name:BEATTY
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:LYNN
Other - Last Name:KEPINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2400 WILDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-6404
Mailing Address - Country:US
Mailing Address - Phone:412-487-7771
Mailing Address - Fax:412-487-7772
Practice Address - Street 1:3950 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1870
Practice Address - Country:US
Practice Address - Phone:724-519-7722
Practice Address - Fax:724-519-2910
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103361439-0001Medicaid
PA103361439-0003Medicaid