Provider Demographics
NPI:1598401895
Name:HAYDEN, CHRISTINA E (CTRS, CCLS, CPMT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:E
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:CTRS, CCLS, CPMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6406 N 159TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-4055
Mailing Address - Country:US
Mailing Address - Phone:916-799-0134
Mailing Address - Fax:
Practice Address - Street 1:6406 N 159TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-4055
Practice Address - Country:US
Practice Address - Phone:916-799-0134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58504225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist