Provider Demographics
NPI:1710365424
Name:SPENCER, CHRISTI (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 EAGLE NEST CIR
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5923
Mailing Address - Country:US
Mailing Address - Phone:808-554-3033
Mailing Address - Fax:
Practice Address - Street 1:1651 EAGLE NEST CIR
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5923
Practice Address - Country:US
Practice Address - Phone:808-554-3033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18156235Z00000X
FLSA 10801235Z00000X
HI619235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist