Provider Demographics
NPI:1649098682
Name:MASTERS, CHRISTA ANN
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:ANN
Last Name:MASTERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BARTHOLOMEW RD
Mailing Address - Street 2:
Mailing Address - City:MERCER
Mailing Address - State:PA
Mailing Address - Zip Code:16137-2504
Mailing Address - Country:US
Mailing Address - Phone:724-866-4702
Mailing Address - Fax:
Practice Address - Street 1:120 BARTHOLOMEW RD
Practice Address - Street 2:
Practice Address - City:MERCER
Practice Address - State:PA
Practice Address - Zip Code:16137-2504
Practice Address - Country:US
Practice Address - Phone:724-866-4702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008192235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist