Provider Demographics
NPI:1104903475
Name:BRITTON-HARE, CHRISTIE JEAN (MS, CCC-SP)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:JEAN
Last Name:BRITTON-HARE
Suffix:
Gender:F
Credentials:MS, CCC-SP
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:JEAN
Other - Last Name:BRITTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SP
Mailing Address - Street 1:PO BOX 8836
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-0836
Mailing Address - Country:US
Mailing Address - Phone:518-262-5575
Mailing Address - Fax:
Practice Address - Street 1:35 HACKETT BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3420
Practice Address - Country:US
Practice Address - Phone:518-262-5575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004017-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00953448OtherASHA BOARD CERT