Provider Demographics
NPI:1467431767
Name:CHRISTIANSEN, JANICE (LGC)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:
Last Name:CHRISTIANSEN
Suffix:
Gender:F
Credentials:LGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ABBOTSFORD DR
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3914
Mailing Address - Country:US
Mailing Address - Phone:302-893-0052
Mailing Address - Fax:
Practice Address - Street 1:146 S LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:GIBBSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08026-1018
Practice Address - Country:US
Practice Address - Phone:856-334-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2000245170300000X
NJ170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170300000XOther Service ProvidersGenetic Counselor, MSGroup - Single Specialty