Provider Demographics
NPI:1346791605
Name:JARRETT, CHRISTINE (MED)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:JARRETT
Suffix:
Gender:F
Credentials:MED
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:DEAPEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6942 W. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033
Mailing Address - Country:US
Mailing Address - Phone:972-658-7831
Mailing Address - Fax:
Practice Address - Street 1:6942 MAIN ST
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4245
Practice Address - Country:US
Practice Address - Phone:972-658-7831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69633101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor