Provider Demographics
NPI:1255658738
Name:DASTGIRI, CRISTINA RAMOS (PHD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:RAMOS
Last Name:DASTGIRI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12335 WAKE UNION CHURCH RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-4527
Mailing Address - Country:US
Mailing Address - Phone:919-562-1080
Mailing Address - Fax:
Practice Address - Street 1:12335 WAKE UNION CHURCH RD
Practice Address - Street 2:SUITE 206
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-4527
Practice Address - Country:US
Practice Address - Phone:919-562-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3393103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent