Provider Demographics
NPI:1730316993
Name:HARBERT, CHRISTINE (CCC/L-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:HARBERT
Suffix:
Gender:F
Credentials:CCC/L-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 E INDUSTRIAL ST
Mailing Address - Street 2:
Mailing Address - City:GODDARD
Mailing Address - State:KS
Mailing Address - Zip Code:67052
Mailing Address - Country:US
Mailing Address - Phone:316-749-6005
Mailing Address - Fax:
Practice Address - Street 1:620 E INDUSTRIAL ST
Practice Address - Street 2:
Practice Address - City:GODDARD
Practice Address - State:KS
Practice Address - Zip Code:67052
Practice Address - Country:US
Practice Address - Phone:316-749-6005
Practice Address - Fax:620-513-3809
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1799235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist