Provider Demographics
NPI:1134681646
Name:SMITH, CHRISTOPHER SAUNIER
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:SAUNIER
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 OLD LEE HWY STE 42B
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2434
Mailing Address - Country:US
Mailing Address - Phone:703-691-0036
Mailing Address - Fax:
Practice Address - Street 1:3911 OLD LEE HWY STE 42B
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2434
Practice Address - Country:US
Practice Address - Phone:703-691-0036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health