Christine Frederick, SLP
Individual provider Active NPI Speech-Language Pathologist · Avondale Estates, GA
NPI 1407155708 · NPPES record last updated Jul 19, 2012
Key facts
- NPI
- 1407155708
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP004644 (GA)
- Practice address
- 3162 Stratford Green PL
Avondale Estates, GA 30002-1341 - Phone
- (770) 853-4614
- NPI assigned
- Mar 25, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP004644 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christine Frederick Speech Therapist LLC | Speech-Language Pathologist | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP004644 | GA | Yes |
Addresses
Primary practice location
3162 Stratford Green PL
Avondale Estates, GA 30002-1341
Mailing address
3162 Stratford Green PL
Avondale Estates, GA 30002-1341
Phone (770) 853-4614
Other names
- Christine Mayle
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All providers in Avondale Estates, GA · Speech-Language Pathologist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.