Provider Demographics
NPI:1962623413
Name:FEDDERS, CHRISTINA L (MS, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:L
Last Name:FEDDERS
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 1:351 ELLA CT
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:KY
Mailing Address - Zip Code:41091-8087
Mailing Address - Country:US
Mailing Address - Phone:859-653-8531
Mailing Address - Fax:
Practice Address - Street 1:51 CAVALIER BLVD STE 230
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-3967
Practice Address - Country:US
Practice Address - Phone:502-633-1007
Practice Address - Fax:502-805-1511
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY139333235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist