Individual
CHARLENE MARIE CHRISTIANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
4529 PORTOFINO DR, LONGMONT, CO 80503-4153
(303) 596-4113
(303) 651-6422
Mailing address
4529 PORTOFINO DR, LONGMONT, CO 80503-4153
(303) 596-4113
(303) 651-6422
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12086516
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77951361
—
CO
Enumeration date
12/04/2006
Last updated
07/09/2007
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