Provider Demographics
NPI:1972840155
Name:DRAWDY, CHRISTIE LYNN (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:LYNN
Last Name:DRAWDY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:SC
Mailing Address - Zip Code:29670-1721
Mailing Address - Country:US
Mailing Address - Phone:864-403-2200
Mailing Address - Fax:864-403-2099
Practice Address - Street 1:315 E QUEEN ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:SC
Practice Address - Zip Code:29670-1721
Practice Address - Country:US
Practice Address - Phone:864-403-2200
Practice Address - Fax:864-403-2099
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4141235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1942275649Medicaid