Doctor Name: | CHRISTINA D IDAR |
NPI Number: | 1043482318 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CCC-SLP |
License Number: | 101644 |
Business Practice Address: | 6655 First Park Ten Blvd Suite 200 San Antonio, TX - 782134308 |
Business Phone Number: | 2107378090 |
Business Fax Number: | |
Mailing Address: | 3403 Lura Ln, SAN ANTONIO |
State: | TX |
Postal Code: | 782282358 |
Phone Number: | 2104357373 |
Fax Number: | |
NPI Enumeration Date: | 03/27/2008 |
NPI Last Update Date: | 03/27/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 101644 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |