Provider Demographics
NPI:1740411586
Name:FIDLER, CHRISTOPHER JAMES I (MS CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:JAMES
Last Name:FIDLER
Suffix:I
Gender:M
Credentials:MS CCC-SLP
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Mailing Address - Street 1:7437 UNION MILL CT
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-2297
Mailing Address - Country:US
Mailing Address - Phone:801-633-3104
Mailing Address - Fax:801-280-8059
Practice Address - Street 1:485 W 1400 N
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-7000
Practice Address - Country:US
Practice Address - Phone:801-426-4905
Practice Address - Fax:801-426-4953
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT7049370-4102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist