Provider Demographics
NPI:1790535276
Name:CHRISTENSON, MADELEINE GABRIELLE (MT-BC)
Entity Type:Individual
Prefix:
First Name:MADELEINE
Middle Name:GABRIELLE
Last Name:CHRISTENSON
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:MADELEINE
Other - Middle Name:GABRIELLE
Other - Last Name:DORIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT-BC
Mailing Address - Street 1:1001 ISLINGTON ST APT 47
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7212
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:750 CENTRAL AVE STE U
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-3434
Practice Address - Country:US
Practice Address - Phone:603-978-4808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist