Provider Demographics
NPI:1891855839
Name:WIEDMEYER, CHRISTINE M (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:WIEDMEYER
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:M
Other - Last Name:SCHWARTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-A
Mailing Address - Street 1:1810 OREGON PIKE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-6470
Mailing Address - Country:US
Mailing Address - Phone:717-397-4741
Mailing Address - Fax:717-291-1830
Practice Address - Street 1:1810 OREGON PIKE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-6470
Practice Address - Country:US
Practice Address - Phone:717-397-4741
Practice Address - Fax:717-291-1830
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT005987231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist