Christy A Bryant, MS, CCC-SLP, L
Individual provider Active NPI Speech-Language Pathologist · South Roxana, IL
NPI 1437660313 · NPPES record last updated Oct 18, 2017
Key facts
- NPI
- 1437660313
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 146.006846 (IL)
- Practice address
- 414 Indiana Ave
South Roxana, IL 62087-1628 - Phone
- (618) 254-5114
- NPI assigned
- Oct 18, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146.006846 | IL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 146.006846 | IL | Yes |
Addresses
Primary practice location
414 Indiana Ave
South Roxana, IL 62087-1628
Mailing address
414 Indiana Ave
South Roxana, IL 62087-1628
Phone (618) 254-5114
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 146.006846 | Other | LICENSE |
Other providers in South Roxana, IL
All providers in South Roxana, IL · Speech-Language Pathologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2017. 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.