Provider Demographics
NPI:1104181643
Name:SHAVER, CHRISTINA L (MS, SPEC ED)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:SHAVER
Suffix:
Gender:F
Credentials:MS, SPEC ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:774 FAIRMOUNT AVE
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-2609
Mailing Address - Country:US
Mailing Address - Phone:716-338-0668
Mailing Address - Fax:866-694-4979
Practice Address - Street 1:774 FAIRMOUNT AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-2609
Practice Address - Country:US
Practice Address - Phone:716-338-0668
Practice Address - Fax:866-694-4979
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist