Provider Demographics
NPI:1528515921
Name:CHRISTOFFERSON, RYLEE
Entity type:Individual
Prefix:
First Name:RYLEE
Middle Name:
Last Name:CHRISTOFFERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RYLEE
Other - Middle Name:
Other - Last Name:VATERLAUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CFY-SLP
Mailing Address - Street 1:8740 ORION PL
Mailing Address - Street 2:SUITE 110
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43240-4053
Mailing Address - Country:US
Mailing Address - Phone:614-734-7777
Mailing Address - Fax:
Practice Address - Street 1:8740 ORION PL
Practice Address - Street 2:SUITE110
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43240-4053
Practice Address - Country:US
Practice Address - Phone:614-734-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2017053-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist