Provider Demographics
NPI:1316911639
Name:SEABORG, CHRISTINA (AUD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:SEABORG
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 CARMEL FOREST DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-8115
Mailing Address - Country:US
Mailing Address - Phone:704-542-3339
Mailing Address - Fax:704-846-2911
Practice Address - Street 1:3601 CARMEL FOREST DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-8115
Practice Address - Country:US
Practice Address - Phone:704-542-3339
Practice Address - Fax:704-846-2911
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5316231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
S46896Medicare UPIN
NC2520986Medicare ID - Type Unspecified