Provider Demographics
NPI:1881241719
Name:TOLLIVER, CHRISTINE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:TOLLIVER
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 1:407 TRIMBLE RD
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-4099
Mailing Address - Country:US
Mailing Address - Phone:410-612-1546
Mailing Address - Fax:
Practice Address - Street 1:407 TRIMBLE RD
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-3727
Practice Address - Country:US
Practice Address - Phone:410-612-1546
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist