Provider Demographics
NPI:1639875222
Name:CHRISTON, KARL
Entity Type:Individual
Prefix:MR
First Name:KARL
Middle Name:
Last Name:CHRISTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4112 HELENS POUROFF AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89085-4460
Mailing Address - Country:US
Mailing Address - Phone:702-610-4961
Mailing Address - Fax:
Practice Address - Street 1:4112 HELENS POUROFF AVE
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89085-4460
Practice Address - Country:US
Practice Address - Phone:702-610-4961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician