Provider Demographics
NPI:1548638588
Name:BURRIS, CHRISTINE RAE
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:RAE
Last Name:BURRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:RAE
Other - Last Name:HAWLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1876 E SABIN DR STE 15
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-6198
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1876 E SABIN DR
Practice Address - Street 2:#1
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-6197
Practice Address - Country:US
Practice Address - Phone:520-792-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2016-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA9643231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist