Provider Demographics
NPI:1093421224
Name:CHRISTOPHEL, VICKIE L
Entity Type:Individual
Prefix:
First Name:VICKIE
Middle Name:L
Last Name:CHRISTOPHEL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:VICKIE
Other - Middle Name:LYNN
Other - Last Name:CHRISTOPHEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:351 E PIKE ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45118-9005
Mailing Address - Country:US
Mailing Address - Phone:513-544-0218
Mailing Address - Fax:
Practice Address - Street 1:351 E PIKE ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:OH
Practice Address - Zip Code:45118-9005
Practice Address - Country:US
Practice Address - Phone:513-544-0218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services