Provider Demographics
NPI:1740628809
Name:POCHETTI, CHRISTINE
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:POCHETTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8745 NE 4TH AVENUE RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-3174
Mailing Address - Country:US
Mailing Address - Phone:203-994-9188
Mailing Address - Fax:
Practice Address - Street 1:13503 SW 104TH CT
Practice Address - Street 2:STE. E-15
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-6033
Practice Address - Country:US
Practice Address - Phone:305-979-9988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-11
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA12173235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist