Provider Demographics
NPI:1912229246
Name:MULVEY, CHRISTINE M (SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:MULVEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2238 E. GINTER ROAD
Mailing Address - Street 2:SUNNYSIDE UNIFIED SCHOOL DISTRICT NO. 12
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85706
Mailing Address - Country:US
Mailing Address - Phone:520-545-2137
Mailing Address - Fax:520-545-2024
Practice Address - Street 1:2238 E. GINTER ROAD
Practice Address - Street 2:SUNNYSIDE UNIFIED SCHOOL DISTRICT NO. 12
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85706
Practice Address - Country:US
Practice Address - Phone:520-545-2137
Practice Address - Fax:520-545-2024
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
AZ235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ978098Medicaid
AZSLP7077OtherAZ DEPT HEALTH SERVICE