Christina M. Petrick, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA 8168 Issued in FL

Practice address

410 10TH Ave W
Palmetto, FL 34221-5032

Phone

(941) 722-3582

Fax

(941) 729-8322

NPI assigned

Sep 22, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1881794584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 10TH AVE W",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342215032",
            "telephone_number": "941-722-3582",
            "fax_number": "941-729-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 10TH AVE W",
            "city": "PALMETTO",
            "state": "FL",
            "postal_code": "342215032",
            "telephone_number": "941-722-3582",
            "fax_number": "941-729-8322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICK",
        "first_name": "CHRISTINA",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 8168",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "811916300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "892150400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tonya L Patterson
• Vanessa Adrienne Paul, APRN
• Claudia Marie Pedro, DC
• Paola Krystal Perez Rodriguez, MD
• Carla Petree
• Pharmcare USA of Florida LLC
• Nakesha Sherina Phillips
• Mandy Poginy, APRN
• Josephine Richardson Polch, ARNP
• Vivian Ilene Polin, OTR

• Speech-Language Pathologist in Palmetto, FL
• Providers in Palmetto, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.