Individual
CRISTA MARIE MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
6430 PLANTATION PARK CT STE 200, FORT MYERS, FL 33966-4816
(392) 151-0252
Mailing address
6360 TECHSTER BLVD STE 1, FORT MYERS, FL 33966-4805
(239) 223-2751
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA16777
FL
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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