Provider Demographics
NPI:1801322490
Name:BAYURA, CHRISTINA (MA CCC-SLP/L)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:BAYURA
Suffix:
Gender:F
Credentials:MA CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 OAK LN
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:PA
Mailing Address - Zip Code:17078-2922
Mailing Address - Country:US
Mailing Address - Phone:717-439-6869
Mailing Address - Fax:
Practice Address - Street 1:620 PAXTON PL
Practice Address - Street 2:SUITE 102
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-8279
Practice Address - Country:US
Practice Address - Phone:717-381-0709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012569235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist