Provider Demographics
NPI:1528180700
Name:DUNCAN, CHRISTINA L (PHD)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:L
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:D
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:519 LATHAM DRIVE
Mailing Address - Street 2:CENTER FOR CHILDREN
Mailing Address - City:LOWELL
Mailing Address - State:AR
Mailing Address - Zip Code:72745
Mailing Address - Country:US
Mailing Address - Phone:479-750-0125
Mailing Address - Fax:479-750-0323
Practice Address - Street 1:519 LATHAM DR
Practice Address - Street 2:CENTER FOR CHILDREN
Practice Address - City:LOWELL
Practice Address - State:AR
Practice Address - Zip Code:72745-8360
Practice Address - Country:US
Practice Address - Phone:479-750-0125
Practice Address - Fax:479-750-0323
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR08-09P103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR175864719Medicaid
AD439ZMedicare PIN
AR5U282Medicare PIN
P96942Medicare UPIN