Healthcare Provider Details

I. General information

NPI: 1508421892
Provider Name (Legal Business Name): CRISTINA SAKTHIVEL M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2019
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81030 GRICIGNANO DI AVERSA
NAPLES ITALY
81030
IT

IV. Provider business mailing address

PSC 808 BOX 819
FPO AE
09618-0009
US

V. Phone/Fax

Practice location:
  • Phone: 81-568-5547
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number18424
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: