Provider Demographics
NPI:1942558945
Name:COREAS, CHRISTINA MARIE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:MARIE
Last Name:COREAS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:VILLONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22 DOME LANE
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-1816
Mailing Address - Country:US
Mailing Address - Phone:516-355-1051
Mailing Address - Fax:
Practice Address - Street 1:22 DOME LANE
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-1816
Practice Address - Country:US
Practice Address - Phone:516-355-1051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-22
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022095235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist