Provider Demographics
NPI:1922558576
Name:PORTER, CHRISTI (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:
Last Name:PORTER
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 1:1844 E BASELINE RD
Mailing Address - Street 2:STE C5
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1506
Mailing Address - Country:US
Mailing Address - Phone:480-833-1005
Mailing Address - Fax:480-833-1312
Practice Address - Street 1:5228 E BARWICK DR
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331
Practice Address - Country:US
Practice Address - Phone:602-697-0670
Practice Address - Fax:480-314-1056
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP2030235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist