Provider Demographics
NPI:1922114941
Name:KROYER-HAGGARD, CHRISTINE MARTIN (MED)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARTIN
Last Name:KROYER-HAGGARD
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BRIERCROFT OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79412-3040
Mailing Address - Country:US
Mailing Address - Phone:806-767-9007
Mailing Address - Fax:806-767-9045
Practice Address - Street 1:19 BRIERCROFT OFFICE PARK
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-3040
Practice Address - Country:US
Practice Address - Phone:806-767-9007
Practice Address - Fax:806-767-9045
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16784101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional