Provider Demographics
NPI:1851552681
Name:CORRAL-PARSONS, CHRISTINE DENICE (MA,LASAC)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:DENICE
Last Name:CORRAL-PARSONS
Suffix:
Gender:F
Credentials:MA,LASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 S CAMINO SECO
Mailing Address - Street 2:#330
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-2805
Mailing Address - Country:US
Mailing Address - Phone:520-721-9645
Mailing Address - Fax:
Practice Address - Street 1:3411 S CAMINO SECO
Practice Address - Street 2:#330
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-2805
Practice Address - Country:US
Practice Address - Phone:520-721-9645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13041101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health