Provider Demographics
NPI:1699813220
Name:CRISTE, PATRICIA ANN BEECH (PHD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN BEECH
Last Name:CRISTE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 MAIN ST
Mailing Address - Street 2:BUILDING 2 SUITE 200
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-2085
Mailing Address - Country:US
Mailing Address - Phone:978-851-5199
Mailing Address - Fax:978-851-5561
Practice Address - Street 1:1565 MAIN ST
Practice Address - Street 2:BUILDING 2 SUITE 200
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-2085
Practice Address - Country:US
Practice Address - Phone:978-851-5199
Practice Address - Fax:978-851-5561
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1878101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health