Healthcare Provider Details

I. General information

NPI: 1164978607
Provider Name (Legal Business Name): CHRISTINA SOMERVILLE MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2016
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2023 SUNSET BLVD
STEUBENVILLE OH
43952-1349
US

IV. Provider business mailing address

2023 SUNSET BLVD
STEUBENVILLE OH
43952-1349
US

V. Phone/Fax

Practice location:
  • Phone: 740-283-3347
  • Fax: 740-283-2709
Mailing address:
  • Phone: 740-283-3347
  • Fax: 740-283-2709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP.6264
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: