Provider Demographics
NPI:1447797394
Name:EMMANUEL-DE LUNA, CHRISTINA C
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:C
Last Name:EMMANUEL-DE LUNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:C
Other - Last Name:EMMANUEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:112 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1472
Mailing Address - Country:US
Mailing Address - Phone:302-397-4182
Mailing Address - Fax:
Practice Address - Street 1:2644 KIRKWOOD HWY
Practice Address - Street 2:SUITE 250
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7268
Practice Address - Country:US
Practice Address - Phone:302-397-4182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000792101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health