Provider Demographics
NPI:1861728974
Name:YANNONE, CHRISTINE R (CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:R
Last Name:YANNONE
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1472 CHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-6824
Mailing Address - Country:US
Mailing Address - Phone:707-407-5107
Mailing Address - Fax:
Practice Address - Street 1:1472 CHESTER AVE
Practice Address - Street 2:
Practice Address - City:ARCATA
Practice Address - State:CA
Practice Address - Zip Code:95521-6824
Practice Address - Country:US
Practice Address - Phone:707-407-5107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13646235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist