Provider Demographics
NPI:1871914226
Name:CHRISTIAN, SCOTTIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SCOTTIE
Middle Name:
Last Name:CHRISTIAN
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 1:184 MISTY BROOK CV
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-3533
Mailing Address - Country:US
Mailing Address - Phone:901-634-3824
Mailing Address - Fax:
Practice Address - Street 1:2176 WEST ST STE 206
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3859
Practice Address - Country:US
Practice Address - Phone:901-328-2110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-01
Last Update Date:2014-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3265235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist