Provider Demographics
NPI:1588950620
Name:PRIMO, CHRISTINA ELIZABETH (AUD)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ELIZABETH
Last Name:PRIMO
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 1:7373 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4373
Mailing Address - Country:US
Mailing Address - Phone:225-769-4044
Mailing Address - Fax:225-246-4371
Practice Address - Street 1:7373 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4373
Practice Address - Country:US
Practice Address - Phone:225-769-4044
Practice Address - Fax:225-246-4371
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003873231H00000X
LA6713231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist