Provider Demographics
NPI:1326363235
Name:PAXSON, CHRISTINA HENDERSON (LAC, DIPLAC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:HENDERSON
Last Name:PAXSON
Suffix:
Gender:F
Credentials:LAC, DIPLAC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:R
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DIPLAC, LAC
Mailing Address - Street 1:1342 N BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:VA
Mailing Address - Zip Code:22974-4311
Mailing Address - Country:US
Mailing Address - Phone:434-591-1180
Mailing Address - Fax:434-591-1180
Practice Address - Street 1:1342 N BOSTON RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:VA
Practice Address - Zip Code:22974-4311
Practice Address - Country:US
Practice Address - Phone:434-591-1180
Practice Address - Fax:434-591-1180
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-02
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000211171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0121000211OtherVIRGINIA BOARD OF MEDICINE