Healthcare Provider Details
I. General information
NPI: 1457511669
Provider Name (Legal Business Name): CHRISTINA AKIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/11/2008
Last Update Date: 11/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4950 W 23RD ST
ERIE PA
16506-5802
US
IV. Provider business mailing address
4950 W 23RD ST
ERIE PA
16506-5802
US
V. Phone/Fax
- Phone: 814-459-2755
- Fax: 814-456-4873
- Phone: 814-459-2755
- Fax: 814-456-4873
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | SL009199 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | 018115-1 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: