Provider Demographics
NPI:1780137083
Name:STAUBITZ, CHRISTINA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:STAUBITZ
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 1:4900 SHAMROCK DR
Mailing Address - Street 2:STE 100-102
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-7328
Mailing Address - Country:US
Mailing Address - Phone:812-479-7337
Mailing Address - Fax:812-550-1990
Practice Address - Street 1:4900 SHAMROCK DR
Practice Address - Street 2:STE 100-102
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-7328
Practice Address - Country:US
Practice Address - Phone:812-479-7337
Practice Address - Fax:812-550-1990
Is Sole Proprietor?:No
Enumeration Date:2016-08-03
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22006734A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN46003008AOtherINDIANA