Provider Demographics
NPI:1780103804
Name:WEDESKY, CHRISTINE DAWN (MSCCC/SLP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:DAWN
Last Name:WEDESKY
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 1:812 E JOLLY RD STE 210
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-6825
Mailing Address - Country:US
Mailing Address - Phone:517-237-7350
Mailing Address - Fax:517-346-8291
Practice Address - Street 1:812 E JOLLY RD STE 210
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-6825
Practice Address - Country:US
Practice Address - Phone:517-237-7350
Practice Address - Fax:517-346-8291
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101002392235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist