Provider Demographics
NPI:1124755962
Name:CHARALAMBOUS, CHRISTINA MARIE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:CHARALAMBOUS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:BOUDREAU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:14232 CEDAR POINTE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-5921
Mailing Address - Country:US
Mailing Address - Phone:225-305-3785
Mailing Address - Fax:
Practice Address - Street 1:14232 CEDAR POINTE AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-5921
Practice Address - Country:US
Practice Address - Phone:225-305-3785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist