Provider Demographics
NPI:1093409450
Name:TORRES, CHRISTINE RENEA
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:RENEA
Last Name:TORRES
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 1:2500 N FORT LN TRLR 221
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-8682
Mailing Address - Country:US
Mailing Address - Phone:801-603-4288
Mailing Address - Fax:
Practice Address - Street 1:2500 N FORT LN TRLR 221
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-8682
Practice Address - Country:US
Practice Address - Phone:801-603-4288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-07
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTHSCM-00146251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management