Provider Demographics
NPI:1730122615
Name:ROE, CHRISTA E (AUD,CCC/A)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:E
Last Name:ROE
Suffix:
Gender:F
Credentials:AUD,CCC/A
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:D
Other - Last Name:ESHLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS,ED
Mailing Address - Street 1:1700 S LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-7529
Mailing Address - Country:US
Mailing Address - Phone:717-272-6621
Mailing Address - Fax:717-228-5970
Practice Address - Street 1:1700 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7529
Practice Address - Country:US
Practice Address - Phone:717-272-6621
Practice Address - Fax:717-228-5970
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT001142L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist