Provider Demographics
NPI:1730226960
Name:HORTON, CHRISTY L (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:L
Last Name:HORTON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CARSON CIR
Mailing Address - Street 2:
Mailing Address - City:GROTTOES
Mailing Address - State:VA
Mailing Address - Zip Code:24441-2578
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:708 OLD WHITE HILL RD
Practice Address - Street 2:
Practice Address - City:STUARTS DRAFT
Practice Address - State:VA
Practice Address - Zip Code:24477-3107
Practice Address - Country:US
Practice Address - Phone:540-908-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA12126917OtherAMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION
VA2202004852OtherVA DEPARTMENT BOARD OF AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY