Provider Demographics
NPI:1053745893
Name:SCHAEFER, CHRISTINE MICHELLE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MICHELLE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7617 LITTLE RIVER TPKE
Mailing Address - Street 2:SUITE #310
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-2603
Mailing Address - Country:US
Mailing Address - Phone:703-941-7757
Mailing Address - Fax:
Practice Address - Street 1:7617 LITTLE RIVER TPKE
Practice Address - Street 2:SUITE #310
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2603
Practice Address - Country:US
Practice Address - Phone:703-941-7757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007152235Z00000X
DCSLP000594235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist