Provider Demographics
NPI:1720534365
Name:HUDOCK, CHRISTIN (SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:
Last Name:HUDOCK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:CHRISTIN
Other - Middle Name:
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8028 BROADLAWN DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237
Mailing Address - Country:US
Mailing Address - Phone:412-443-9435
Mailing Address - Fax:
Practice Address - Street 1:105 BURGESS DR
Practice Address - Street 2:
Practice Address - City:ZELIENOPLE
Practice Address - State:PA
Practice Address - Zip Code:16063
Practice Address - Country:US
Practice Address - Phone:724-452-1603
Practice Address - Fax:724-452-2361
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
396794Medicare UPIN
1356349237Medicare PIN