Doctor Name: | CRISTINA FETTER |
NPI Number: | 1841666476 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. CCC/SLP |
License Number: | 22006128A |
Business Practice Address: | 8840 Cypress Waters Blvd Suite 300 Coppell, TX - 750194594 |
Business Phone Number: | 8662170265 |
Business Fax Number: | 8448199147 |
Mailing Address: | 8840 Cypress Waters Blvd, Suite 300 COPPELL |
State: | TX |
Postal Code: | 750194594 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 08/18/2015 |
NPI Last Update Date: | 08/18/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22006128A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
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 |