Provider Demographics
NPI:1366693236
Name:HANCOCK, CHRISTINA R (LISW-S)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:R
Last Name:HANCOCK
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21568 COUNTY ROAD C
Mailing Address - Street 2:
Mailing Address - City:STRYKER
Mailing Address - State:OH
Mailing Address - Zip Code:43557-9709
Mailing Address - Country:US
Mailing Address - Phone:419-682-9163
Mailing Address - Fax:
Practice Address - Street 1:221 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:OH
Practice Address - Zip Code:43506-1759
Practice Address - Country:US
Practice Address - Phone:419-636-8400
Practice Address - Fax:419-636-7953
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.0800265-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical