Provider Demographics
NPI:1225260425
Name:DE QUESADA, CHRISTINA (LPC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:DE QUESADA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:HULL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1401 N CENTRAL EXPY
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-4669
Mailing Address - Country:US
Mailing Address - Phone:972-639-6579
Mailing Address - Fax:214-723-7702
Practice Address - Street 1:1401 N CENTRAL EXPY
Practice Address - Street 2:SUITE 105
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-4669
Practice Address - Country:US
Practice Address - Phone:972-639-6579
Practice Address - Fax:214-723-7702
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62244101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2043242-01Medicaid
TX2043242-02Medicaid