Provider Demographics
NPI:1821219502
Name:WAY, CHRISTINE AB (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:AB
Last Name:WAY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2709 E. WAVERLY STREET
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-3080
Mailing Address - Country:US
Mailing Address - Phone:520-991-6847
Mailing Address - Fax:
Practice Address - Street 1:101 S. STONE AVENUE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-1912
Practice Address - Country:US
Practice Address - Phone:520-884-0707
Practice Address - Fax:520-624-8286
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-122331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical