Basic Information
| Provider Information | |||||||||
| NPI: | 1780093591 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TWELE | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | ROA | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MS CF-SLP | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | ROA | ||||||||
| OtherFirstName: | CHRISTINA | ||||||||
| OtherMiddleName: | MARIA | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 5 DOWD CIR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283747901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102952609 | ||||||||
| FaxNumber: | 9102950026 | ||||||||
| Practice Location | |||||||||
| Address1: | 5 DOWD CIR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | PINEHURST | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283747901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9102952609 | ||||||||
| FaxNumber: | 9102950026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2014 | ||||||||
| LastUpdateDate: | 08/06/2014 | ||||||||
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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 | 235Z00000X | 11067 | NC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.