Provider Demographics
NPI:1699276030
Name:VASQUEZ, CHRISTINA ANNE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:ANNE
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:MCCARTHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:3334 ASPEN RYDER DR
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2644
Mailing Address - Country:US
Mailing Address - Phone:281-460-4049
Mailing Address - Fax:
Practice Address - Street 1:3600 MARGARET ST
Practice Address - Street 2:
Practice Address - City:NEEDVILLE
Practice Address - State:TX
Practice Address - Zip Code:77461-8350
Practice Address - Country:US
Practice Address - Phone:281-460-4049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-21
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2355S0801X
TX117712235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant