Provider Demographics
NPI:1922353648
Name:JEWELL, CHRISTIE Z (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:Z
Last Name:JEWELL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:L
Other - Last Name:ZERINGUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7784 INNOVATION PARK DR.
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-7006
Mailing Address - Country:US
Mailing Address - Phone:225-343-4232
Mailing Address - Fax:225-343-4233
Practice Address - Street 1:7784 INNOVATION PARK DR.
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820
Practice Address - Country:US
Practice Address - Phone:225-343-4232
Practice Address - Fax:225-343-4233
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6649235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist