Provider Demographics
NPI:1366452021
Name:HOWARD, CHRISTINA ANNAMARIE (MSW/LMSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:ANNAMARIE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:MSW/LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-2854
Mailing Address - Country:US
Mailing Address - Phone:810-966-2679
Mailing Address - Fax:
Practice Address - Street 1:230 HURON AVE
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3822
Practice Address - Country:US
Practice Address - Phone:810-966-4476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010781811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIM97240029Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID