Provider Demographics
NPI:1184747537
Name:CURRY,, CHANN-TIA MYCHELLE (MS CMD, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHANN-TIA
Middle Name:MYCHELLE
Last Name:CURRY,
Suffix:
Gender:F
Credentials:MS CMD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 JIB CT
Mailing Address - Street 2:CIRCULAR THERAPEUTICS, PLLC
Mailing Address - City:FRESNO
Mailing Address - State:TX
Mailing Address - Zip Code:77545-8179
Mailing Address - Country:US
Mailing Address - Phone:281-437-4218
Mailing Address - Fax:
Practice Address - Street 1:3307 JIB CT
Practice Address - Street 2:CIRCULAR THERAPEUTICS, PLLC
Practice Address - City:FRESNO
Practice Address - State:TX
Practice Address - Zip Code:77545-8179
Practice Address - Country:US
Practice Address - Phone:281-437-4218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2009-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102174235Z00000X
GASLP006251235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist