Provider Demographics
NPI:1841789393
Name:WATSON SCHMITT, CHRISTIE LYNN
Entity Type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:LYNN
Last Name:WATSON SCHMITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CHRISTIE
Other - Middle Name:LYNN
Other - Last Name:WATSON SCHMITT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICDC
Mailing Address - Street 1:705 S BROWN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-3113
Mailing Address - Country:US
Mailing Address - Phone:937-890-5400
Mailing Address - Fax:
Practice Address - Street 1:705 S BROWN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-3113
Practice Address - Country:US
Practice Address - Phone:937-890-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC.161666101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)