Provider Demographics
NPI:1306016811
Name:RAINER, CHRISTY MAYES (CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:MAYES
Last Name:RAINER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 WHEATON DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35633-1739
Mailing Address - Country:US
Mailing Address - Phone:256-766-5352
Mailing Address - Fax:
Practice Address - Street 1:701 MONROE ST NW
Practice Address - Street 2:
Practice Address - City:RUSSELLVILLE
Practice Address - State:AL
Practice Address - Zip Code:35653-1358
Practice Address - Country:US
Practice Address - Phone:256-332-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2486235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist