Provider Demographics
NPI:1669065579
Name:FIKES, CHRISTINA (MSCCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:
Last Name:FIKES
Suffix:
Gender:F
Credentials:MSCCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6140 CORONADO DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-3727
Mailing Address - Country:US
Mailing Address - Phone:251-463-5175
Mailing Address - Fax:
Practice Address - Street 1:3085 DAUPHIN SQ CONN
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-2517
Practice Address - Country:US
Practice Address - Phone:251-450-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4120235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty