Provider Demographics
NPI:1235525494
Name:CID, CHRISTIAN (MMFT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTIAN
Middle Name:
Last Name:CID
Suffix:
Gender:F
Credentials:MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1181 NASHVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-3165
Mailing Address - Country:US
Mailing Address - Phone:615-681-4773
Mailing Address - Fax:
Practice Address - Street 1:1181 NASHVILLE PIKE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3165
Practice Address - Country:US
Practice Address - Phone:615-681-4773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN740OtherTEMP LIC.