Provider Demographics
NPI:1619562485
Name:AUSTIN CAMPBELL, CHRISTINE LEE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LEE
Last Name:AUSTIN CAMPBELL
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 1:177 SHATTUCK WAY
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7879
Mailing Address - Country:US
Mailing Address - Phone:603-436-0448
Mailing Address - Fax:
Practice Address - Street 1:177 SHATTUCK WAY STE 1
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:NH
Practice Address - Zip Code:03801-7860
Practice Address - Country:US
Practice Address - Phone:603-436-0448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)