Provider Demographics
NPI:1326385816
Name:CHRISTIAN, MYETTE L (MFTT)
Entity Type:Individual
Prefix:
First Name:MYETTE
Middle Name:L
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:MFTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7456 DOHENY CT
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-3511
Mailing Address - Country:US
Mailing Address - Phone:909-204-1294
Mailing Address - Fax:
Practice Address - Street 1:245 N MURRAY ST
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-5528
Practice Address - Country:US
Practice Address - Phone:951-663-8366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator