Provider Demographics
NPI:1821619594
Name:HEINEN, CHRISTINA HENSGENS (SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:HENSGENS
Last Name:HEINEN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:H
Other - Last Name:HEINEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2519 RYAN ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-7323
Mailing Address - Country:US
Mailing Address - Phone:337-491-0800
Mailing Address - Fax:337-491-0508
Practice Address - Street 1:2519 RYAN ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-7323
Practice Address - Country:US
Practice Address - Phone:337-491-0800
Practice Address - Fax:337-491-0508
Is Sole Proprietor?:No
Enumeration Date:2020-05-04
Last Update Date:2020-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist