Individual
CHRISTINA MARIE CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP, MA BCBA
Contact information
Practice address
460 DALTON BLVD, PORT CHARLOTTE, FL 33952-8360
(321) 732-0368
Mailing address
150 AVENUE B SE, WINTER HAVEN, FL 33880-3037
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
235Z00000X
Speech-Language Pathologist
Primary
SA8944
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891244100
—
FL
Enumeration date
09/05/2007
Last updated
07/16/2024
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