Chris Tharrington Waters, M.A., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Hypoluxo, FL
NPI 1730253162 · NPPES record last updated Jun 24, 2011
Key facts
- NPI
- 1730253162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SA 1658 (FL)
- Practice address
- 132 Barefoot CV
Hypoluxo, FL 33462-6508 - Phone
- (850) 339-3975
- NPI assigned
- Nov 18, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 1658 | FL | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA 1658 | FL | Yes |
Addresses
Primary practice location
132 Barefoot CV
Hypoluxo, FL 33462-6508
Mailing address
132 Barefoot CV
Suite 1
Hypoluxo, FL 33462-6508
Phone (850) 339-3975
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 886392000 | Medicaid | FL |
Other providers in Hypoluxo, FL
All providers in Hypoluxo, FL · Speech-Language Pathologist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 24, 2011. 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.