Provider Demographics
NPI:1073738209
Name:LEIST, CHRISTINE POLLARD (MM, MT-BC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:POLLARD
Last Name:LEIST
Suffix:
Gender:F
Credentials:MM, MT-BC
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:L
Other - Last Name:POLLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MM, MT-BC
Mailing Address - Street 1:176 HIDDEN POND RD
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-9115
Mailing Address - Country:US
Mailing Address - Phone:828-262-1992
Mailing Address - Fax:
Practice Address - Street 1:176 HIDDEN POND RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-9115
Practice Address - Country:US
Practice Address - Phone:828-262-1992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist