Provider Demographics
NPI:1790832467
Name:FIELDER, CHRISTINE DOYL (MA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:DOYL
Last Name:FIELDER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 TUMAMOC DR
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86403-4828
Mailing Address - Country:US
Mailing Address - Phone:928-412-8900
Mailing Address - Fax:928-855-4229
Practice Address - Street 1:1951 MESQUITE AVE STE J
Practice Address - Street 2:
Practice Address - City:LAKE HAVASU CITY
Practice Address - State:AZ
Practice Address - Zip Code:86403-5746
Practice Address - Country:US
Practice Address - Phone:928-453-1328
Practice Address - Fax:928-855-4229
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-10841101YA0400X
AZLPC-11218101YP2500X
AZLMFT-10162106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist