Provider Demographics
NPI:1801964135
Name:BRADBURN, CHRISTINA DAWN (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:DAWN
Last Name:BRADBURN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 WINDSTAR BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:IN
Mailing Address - Zip Code:46131-7299
Mailing Address - Country:US
Mailing Address - Phone:317-946-7988
Mailing Address - Fax:317-738-9185
Practice Address - Street 1:874 WINDSTAR BLVD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:IN
Practice Address - Zip Code:46131-7299
Practice Address - Country:US
Practice Address - Phone:317-946-7988
Practice Address - Fax:317-738-9185
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003776A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist