Provider Demographics
NPI:1588147920
Name:SHEW, CHRISTINE MARIE (MS CCC/SLP)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:SHEW
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 WARRINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-6555
Mailing Address - Country:US
Mailing Address - Phone:214-708-0899
Mailing Address - Fax:
Practice Address - Street 1:4060 ABBEY RD.
Practice Address - Street 2:
Practice Address - City:CRANDALL
Practice Address - State:TX
Practice Address - Zip Code:75114-7511
Practice Address - Country:US
Practice Address - Phone:972-427-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100457235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist