Provider Demographics
NPI:1952300683
Name:CONRAD, CHRISTIE-ANN (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIE-ANN
Middle Name:
Last Name:CONRAD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 DEER MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-2253
Mailing Address - Country:US
Mailing Address - Phone:724-941-4434
Mailing Address - Fax:
Practice Address - Street 1:205 DEER MEADOW DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-2253
Practice Address - Country:US
Practice Address - Phone:724-941-4434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL002049L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017607630005Medicaid