Provider Demographics
NPI:1760459390
Name:HARKEY, CHRISTINA ELIZABETH (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ELIZABETH
Last Name:HARKEY
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:MISS
Other - First Name:CHRISTINA
Other - Middle Name:ELIZABETH
Other - Last Name:COOLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSPT
Mailing Address - Street 1:3822 EVERGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-8559
Mailing Address - Country:US
Mailing Address - Phone:269-720-7673
Mailing Address - Fax:
Practice Address - Street 1:925 CITY CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2981
Practice Address - Country:US
Practice Address - Phone:936-202-5235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8305225100000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH382617193OtherTAX ID
OHPT011536OtherSTATE ID
OH0108341Medicaid
OH000000190966OtherBCBS PIN NUMBER
OH000000190966OtherBCBS PIN NUMBER