Provider Demographics
NPI:1750877874
Name:PENNINGER, CHRISTY LOU
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:LOU
Last Name:PENNINGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E PYTHIAN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-2141
Mailing Address - Country:US
Mailing Address - Phone:417-895-6848
Mailing Address - Fax:417-869-6310
Practice Address - Street 1:1601 E PYTHIAN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-2141
Practice Address - Country:US
Practice Address - Phone:417-895-6848
Practice Address - Fax:417-869-6310
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist