Provider Demographics
NPI:1477650661
Name:BABICH, CHRISTINE MASE (MA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MASE
Last Name:BABICH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6300 SASHABAW RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-2269
Mailing Address - Country:US
Mailing Address - Phone:248-620-7947
Mailing Address - Fax:248-620-7947
Practice Address - Street 1:6300 SASHABAW RD
Practice Address - Street 2:SUITE D
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2269
Practice Address - Country:US
Practice Address - Phone:248-620-7947
Practice Address - Fax:248-620-7947
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007134103T00000X, 103TC0700X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent