Provider Demographics
NPI:1477688521
Name:CHRISTIAN, KATYNA (LPC)
Entity Type:Individual
Prefix:
First Name:KATYNA
Middle Name:
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2148
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-0038
Mailing Address - Country:US
Mailing Address - Phone:214-288-8878
Mailing Address - Fax:
Practice Address - Street 1:1546 CHARLESTON DR
Practice Address - Street 2:A
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-0913
Practice Address - Country:US
Practice Address - Phone:214-288-8878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19430101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7247LCOtherBCBS PROVIDER ID