Provider Demographics
NPI:1851679880
Name:STEFONI, CHRISTA GERDA (MS CCC/SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:GERDA
Last Name:STEFONI
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:CHRISTA
Other - Middle Name:GERDA
Other - Last Name:POPOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC/SLP
Mailing Address - Street 1:2222 SULLIVAN TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-7958
Mailing Address - Country:US
Mailing Address - Phone:800-944-9782
Mailing Address - Fax:610-438-2046
Practice Address - Street 1:1740 S SAN DIMAS AVE
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-5108
Practice Address - Country:US
Practice Address - Phone:909-394-0304
Practice Address - Fax:909-305-4647
Is Sole Proprietor?:No
Enumeration Date:2011-07-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP18107235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist