Provider Demographics
NPI:1326327883
Name:SMITH, CHRISTINA MARIE (BCBA)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:RACZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:374 MERIDIAN PARKE LN
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-9406
Mailing Address - Country:US
Mailing Address - Phone:317-889-5437
Mailing Address - Fax:317-436-8911
Practice Address - Street 1:374 MERIDIAN PARKE LN
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46142-9406
Practice Address - Country:US
Practice Address - Phone:317-889-5437
Practice Address - Fax:317-436-8911
Is Sole Proprietor?:No
Enumeration Date:2011-08-15
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst