Provider Demographics
NPI:1750036919
Name:PROUHET, CHRISTINA R (RBT)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:R
Last Name:PROUHET
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 REYNOLDS AVE
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-4122
Mailing Address - Country:US
Mailing Address - Phone:171-354-0286
Mailing Address - Fax:
Practice Address - Street 1:709 REYNOLDS AVE
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-4122
Practice Address - Country:US
Practice Address - Phone:713-540-2868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXRBT-21-150046106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician