Christina K Heinemann, MA CCCSLP

Individual provider Active NPI Speech-Language Pathologist · Tombstone, AZ

NPI 1962501767 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1962501767
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP1558 (AZ)
Practice address
805 E Freemont
Tombstone Unified School District #1
Tombstone, AZ 85638
Phone
(520) 457-2217
Fax
(520) 457-3270
NPI assigned
Sep 21, 2006
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 Arts

State licenses

LicenseStateTypeSpecialty
SLP1558AZMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP1558 AZ Yes

Addresses

Primary practice location

805 E Freemont
Tombstone Unified School District #1
Tombstone, AZ 85638

Mailing address

PO Box 610
Hereford, AZ 85615
Phone (520) 940-3233

Other identifiers

IdentifierTypeStateIssuer
752510MedicaidAZ

Other providers in Tombstone, AZ

All providers in Tombstone, AZ · Speech-Language Pathologist in Arizona

Sources for this page

Verify at the official NPI Registry.