Provider Demographics
NPI:1174865505
Name:GOVAN, CHRISTIE NECHOLE
Entity Type:Individual
Prefix:MISS
First Name:CHRISTIE
Middle Name:NECHOLE
Last Name:GOVAN
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 1:701 HETTIE ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76209-4511
Mailing Address - Country:US
Mailing Address - Phone:469-671-1658
Mailing Address - Fax:
Practice Address - Street 1:701 HETTIE ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76209-4511
Practice Address - Country:US
Practice Address - Phone:469-671-1658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-24
Last Update Date:2013-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health