Provider Demographics
NPI:1629169073
Name:GUY, CHRISTINE DRYLAK (MS, CMHP)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:DRYLAK
Last Name:GUY
Suffix:
Gender:F
Credentials:MS, CMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 TREE POINT DR
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32547-1898
Mailing Address - Country:US
Mailing Address - Phone:850-864-5400
Mailing Address - Fax:850-864-5473
Practice Address - Street 1:1079 TREE POINT DR
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32547-1898
Practice Address - Country:US
Practice Address - Phone:850-864-5400
Practice Address - Fax:854-864-5473
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL760569200Medicaid
FL760569200Medicaid