Provider Demographics
NPI:1609157882
Name:CHRISTIANSEN, SHAWN (PHD)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:CHRISTIANSEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 N MAIN ST STE 301
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-9791
Mailing Address - Country:US
Mailing Address - Phone:435-586-4479
Mailing Address - Fax:435-865-0023
Practice Address - Street 1:2202 N MAIN ST STE 301
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-9791
Practice Address - Country:US
Practice Address - Phone:435-586-4479
Practice Address - Fax:435-865-0023
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker