Provider Demographics
NPI:1700056199
Name:VITIELLO, CHRISTIE LYNN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:LYNN
Last Name:VITIELLO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10725 SW 104 STREET
Mailing Address - Street 2:KENDALL SPEECH AND LANGUAGE CENTER
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176
Mailing Address - Country:US
Mailing Address - Phone:305-274-7883
Mailing Address - Fax:305-274-4271
Practice Address - Street 1:10725 SW 104 STREET
Practice Address - Street 2:KENDALL SPEECH AND LANGUAGE CENTER
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-8162
Practice Address - Country:US
Practice Address - Phone:305-274-7883
Practice Address - Fax:305-274-4271
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 4241235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist