Provider Demographics
NPI:1659446771
Name:CHOU, CHRISTINA PEY-RU (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:PEY-RU
Last Name:CHOU
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 PARK PLACE AVE.
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110
Mailing Address - Country:US
Mailing Address - Phone:817-921-2401
Mailing Address - Fax:817-921-2405
Practice Address - Street 1:1616 PARK PLACE AVE.
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110
Practice Address - Country:US
Practice Address - Phone:817-921-2401
Practice Address - Fax:817-921-2405
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106H00000X
TX201211106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist