Provider Demographics
NPI:1043918964
Name:SLIWOSKI, CHRISTINA M
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:SLIWOSKI
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 1:859 FULLER HILL RD
Mailing Address - Street 2:
Mailing Address - City:WHITINGHAM
Mailing Address - State:VT
Mailing Address - Zip Code:05361-9799
Mailing Address - Country:US
Mailing Address - Phone:508-641-6727
Mailing Address - Fax:
Practice Address - Street 1:859 FULLER HILL RD
Practice Address - Street 2:
Practice Address - City:WHITINGHAM
Practice Address - State:VT
Practice Address - Zip Code:05361-9799
Practice Address - Country:US
Practice Address - Phone:508-641-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MABACB381579106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician