Provider Demographics
NPI:1841366192
Name:MADDUX, CHRISTY ANN (MS CCC-A)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:ANN
Last Name:MADDUX
Suffix:
Gender:F
Credentials:MS CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 BROADWAY ST
Mailing Address - Street 2:SUITE 509
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-2658
Mailing Address - Country:US
Mailing Address - Phone:816-531-7373
Mailing Address - Fax:816-531-1404
Practice Address - Street 1:3100 BROADWAY ST
Practice Address - Street 2:SUITE 509
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-2658
Practice Address - Country:US
Practice Address - Phone:816-531-7373
Practice Address - Fax:816-531-1404
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002029424231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO36200011OtherBCBS SERVICING PROVIDER N
MO352249355OtherTAX ID
MO36219011OtherBCBS GROUP NUMBER