Provider Demographics
NPI:1609994805
Name:CRAIN, CHRISTINE (MS)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:CRAIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 E ROSE LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-1600
Mailing Address - Country:US
Mailing Address - Phone:602-664-7430
Mailing Address - Fax:
Practice Address - Street 1:1155 E ROSE LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-1600
Practice Address - Country:US
Practice Address - Phone:602-664-7430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool