Provider Demographics
NPI:1356660245
Name:LEVASSEUR, CHRISTINA N
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:N
Last Name:LEVASSEUR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 E BELLA VISTA ST
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33805-3009
Mailing Address - Country:US
Mailing Address - Phone:863-683-6504
Mailing Address - Fax:
Practice Address - Street 1:716 E BELLA VISTA ST
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-3009
Practice Address - Country:US
Practice Address - Phone:863-683-6504
Practice Address - Fax:863-688-9292
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-18
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist