Basic Information
| Provider Information | |||||||||
| NPI: | 1659723542 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHRISTIANSEN | ||||||||
| FirstName: | IOANNA | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1901 FLOYD ST | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342392932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9413669222 | ||||||||
| FaxNumber: | 9413652269 | ||||||||
| Practice Location | |||||||||
| Address1: | 1901 FLOYD ST | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342392932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9413669222 | ||||||||
| FaxNumber: | 9413652269 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2016 | ||||||||
| LastUpdateDate: | 01/12/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AY2039 | FL | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.