Provider Demographics
NPI:1922011469
Name:TOBIN, CHRISTINE ROSE (AUD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ROSE
Last Name:TOBIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 6TH AVENUE
Mailing Address - Street 2:STE. 109
Mailing Address - City:PRINCETON
Mailing Address - State:MN
Mailing Address - Zip Code:55371
Mailing Address - Country:US
Mailing Address - Phone:763-631-3277
Mailing Address - Fax:
Practice Address - Street 1:101 6TH AVENUE
Practice Address - Street 2:STE. 109
Practice Address - City:PRINCETON
Practice Address - State:MN
Practice Address - Zip Code:55371
Practice Address - Country:US
Practice Address - Phone:763-631-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2012-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6301231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN640000325OtherMEDICARE- TYPE UNSPECIFIE
MN640000325OtherMEDICARE- TYPE UNSPECIFIE