Provider Demographics
NPI:1881036788
Name:HEIBERGER, CHRISTINA JEAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JEAN
Last Name:HEIBERGER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 17TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-5639
Mailing Address - Country:US
Mailing Address - Phone:605-626-1187
Mailing Address - Fax:605-626-4391
Practice Address - Street 1:2905 3RD AVE SE
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-5420
Practice Address - Country:US
Practice Address - Phone:605-626-4380
Practice Address - Fax:605-626-4391
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12123521235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist