Provider Demographics
NPI:1043806490
Name:WILLIAMS, CHRISTINA LYNNE
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYNNE
Last Name:WILLIAMS
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 1:37 ELIZABETH DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:WV
Mailing Address - Zip Code:26452-7057
Mailing Address - Country:US
Mailing Address - Phone:304-269-5220
Mailing Address - Fax:
Practice Address - Street 1:37 ELIZABETH DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WV
Practice Address - Zip Code:26452-7057
Practice Address - Country:US
Practice Address - Phone:304-269-5220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator