Provider Demographics
NPI:1508048380
Name:WESTGARD, CHRISTIN L
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:L
Last Name:WESTGARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N 4TH ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-4068
Mailing Address - Country:US
Mailing Address - Phone:402-750-0401
Mailing Address - Fax:
Practice Address - Street 1:123 N 4TH ST
Practice Address - Street 2:SUITE 8
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4068
Practice Address - Country:US
Practice Address - Phone:402-750-0401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8109101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health