Provider Demographics
NPI:1689256554
Name:MCADAM, CRISTINA ANNE
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:ANNE
Last Name:MCADAM
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 1:1261 RED FOX TRL
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:GA
Mailing Address - Zip Code:30621-6117
Mailing Address - Country:US
Mailing Address - Phone:678-787-1304
Mailing Address - Fax:
Practice Address - Street 1:3070 BUSINESS PARK DR
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-5404
Practice Address - Country:US
Practice Address - Phone:770-884-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician