Provider Demographics
NPI:1497445324
Name:STOUDT, CHRISTIE JANE (RCYATH)
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:JANE
Last Name:STOUDT
Suffix:
Gender:F
Credentials:RCYATH
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:JANE
Other - Last Name:HENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RCYATH
Mailing Address - Street 1:614 S MAIN ST STE 1
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:SD
Mailing Address - Zip Code:57401-9407
Mailing Address - Country:US
Mailing Address - Phone:605-626-1509
Mailing Address - Fax:
Practice Address - Street 1:614 S MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:SD
Practice Address - Zip Code:57401-9407
Practice Address - Country:US
Practice Address - Phone:605-626-1509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-12
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator