Provider Demographics
NPI:1699495366
Name:CHRISTIANSEN, ABBEY RENEE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ABBEY
Middle Name:RENEE
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:ABBEY
Other - Middle Name:RENEE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2705 CRATER LAKE LN
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-3378
Mailing Address - Country:US
Mailing Address - Phone:409-291-9874
Mailing Address - Fax:
Practice Address - Street 1:600 LIBERTY RD
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-2356
Practice Address - Country:US
Practice Address - Phone:972-347-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116978235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty