Provider Demographics
NPI:1912475641
Name:FOREMAN, CHRISTINA SIMPSON (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:SIMPSON
Last Name:FOREMAN
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 1:31481 OLD OCEAN CITY RD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-1810
Mailing Address - Country:US
Mailing Address - Phone:410-677-5101
Mailing Address - Fax:410-677-5188
Practice Address - Street 1:31481 OLD OCEAN CITY RD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-1810
Practice Address - Country:US
Practice Address - Phone:410-677-5101
Practice Address - Fax:410-677-5188
Is Sole Proprietor?:No
Enumeration Date:2018-11-12
Last Update Date:2018-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06120235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist