Provider Demographics
NPI:1740605070
Name:STALLMAN, CHRIS (MS, LCGC)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:STALLMAN
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:ANNE
Other - Last Name:COLON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8602 E COLETTE ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2537
Mailing Address - Country:US
Mailing Address - Phone:917-642-2509
Mailing Address - Fax:
Practice Address - Street 1:1295 NORTH MARTIN AVE SUITE 430
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85721-2771
Practice Address - Country:US
Practice Address - Phone:520-626-1621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-24
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGC000445170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS