Provider Demographics
NPI:1114152261
Name:CRAIGIN, CHRISTINE M (MS)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:CRAIGIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 BOILERMAKER CT
Mailing Address - Street 2:1C
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-8412
Mailing Address - Country:US
Mailing Address - Phone:219-286-7043
Mailing Address - Fax:219-246-4655
Practice Address - Street 1:2803 BOILERMAKER CT
Practice Address - Street 2:1C
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-8412
Practice Address - Country:US
Practice Address - Phone:219-286-7043
Practice Address - Fax:219-246-4655
Is Sole Proprietor?:No
Enumeration Date:2009-05-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35001805A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist