Provider Demographics
NPI:1538796891
Name:MAKOWSKI, CHRISTINA D (MA,CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:D
Last Name:MAKOWSKI
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:D
Other - Last Name:GOODFELLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,CCC-SLP
Mailing Address - Street 1:450 AVON BELDEN RD
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-2282
Mailing Address - Country:US
Mailing Address - Phone:440-930-4512
Mailing Address - Fax:440-930-2823
Practice Address - Street 1:450 AVON BELDEN RD
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-2282
Practice Address - Country:US
Practice Address - Phone:440-930-4512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP04842235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist