Provider Demographics
NPI:1740615830
Name:DEFURIA, CRISTINA ELIZABETH (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:ELIZABETH
Last Name:DEFURIA
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 1:288 MORRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-4209
Mailing Address - Country:US
Mailing Address - Phone:732-742-6572
Mailing Address - Fax:
Practice Address - Street 1:1610 ROUTE 88 W
Practice Address - Street 2:SUITE 204
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3018
Practice Address - Country:US
Practice Address - Phone:732-742-6572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-07
Last Update Date:2013-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FL00173100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist