Individual
CHRISTINA J FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4950 PARKSIDE AVE, PHILADELPHIA, PA 19131-4700
(215) 879-4023
Mailing address
5500 WINDSOR AVE, PHILADELPHIA, PA 19143-4725
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL013796
PA
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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