Provider Demographics
NPI:1487167938
Name:ZELNIK, CHRISTINE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:ZELNIK
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 D ST APT 214
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-4560
Mailing Address - Country:US
Mailing Address - Phone:734-474-6383
Mailing Address - Fax:
Practice Address - Street 1:1100 MAIN ST STE 190
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3515
Practice Address - Country:US
Practice Address - Phone:530-662-2835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25283235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist