Provider Demographics
NPI:1083666929
Name:CHRISTIE, HUGH ALLEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:HUGH
Middle Name:ALLEN
Last Name:CHRISTIE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220C W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4121
Mailing Address - Country:US
Mailing Address - Phone:770-228-9317
Mailing Address - Fax:770-228-8397
Practice Address - Street 1:220C W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4121
Practice Address - Country:US
Practice Address - Phone:770-228-9317
Practice Address - Fax:770-228-8397
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY000516103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00137574AMedicaid
GA00137574AMedicaid