MEDICARE: CHRISTI SPENCER MA CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	18156	CA
2	235Z00000X	Speech-Language Pathologist	SA 10801	FL
3	235Z00000X	Speech-Language Pathologist	619	HI

General Provider Information

NPI Number	:	1710365424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTI SPENCER MA CCC-SLP

Provider Business Mailing Address
First Line	:	1651 EAGLE NEST CIR
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-5923
Country	:	US
Telephone Number	:	808-554-3033
Fax Number	:

Provider Business Practice Location Address
First Line	:	1651 EAGLE NEST CIR
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-5923
Country	:	US
Telephone Number	:	808-554-3033
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2015
Last Update Date	:	05/13/2015

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Directions to “ CHRISTI SPENCER MA CCC-SLP” Practice Location

Language	Start Address	Practice Location

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