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General NPI Number Information
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NPI Number | 1851187215
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Entity Type | Organization
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Legal Business Name | CHRISTINA CID LLC
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 515 S SANTA FE AVE STE 104
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City | EDMOND
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State | OK
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Zip | 73003-6286
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Country | US
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Telephone | 405-413-2655
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Fax |
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Provider Business Mailing Address
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Address Line | 13176 CHINKAPIN OAK PL
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City | CHOCTAW
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State | OK
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Zip | 73020-2006
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Country | US
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Telephone | 405-413-2655
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Fax |
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | CHRISTINA CID
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Credential | MS CCC-SLP
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Telephone | 405-413-2655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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