Provider Demographics
NPI:1104090554
Name:CLEMENS, CRISTINA MARIE (MS CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:MARIE
Last Name:CLEMENS
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:95 MAHALANI ST
Mailing Address - Street 2:ST 19A
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793
Mailing Address - Country:US
Mailing Address - Phone:808-244-7467
Mailing Address - Fax:808-242-4762
Practice Address - Street 1:95 MAHALANI ST
Practice Address - Street 2:ST 19A
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793
Practice Address - Country:US
Practice Address - Phone:808-244-7467
Practice Address - Fax:808-242-4762
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist