Provider Demographics
NPI:1114801214
Name:CHRISTOFIDIS, MICHELLE THERESA HASENKAMPF (MSCCCSLP)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:THERESA HASENKAMPF
Last Name:CHRISTOFIDIS
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:118 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39406-0002
Mailing Address - Country:US
Mailing Address - Phone:601-266-5222
Mailing Address - Fax:601-266-6566
Practice Address - Street 1:118 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39406-0002
Practice Address - Country:US
Practice Address - Phone:601-266-5222
Practice Address - Fax:601-266-6566
Is Sole Proprietor?:No
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS-5082235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist