Provider Demographics
NPI:1922287473
Name:PRYOR, CHRISTIN K (PHD,LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTIN
Middle Name:K
Last Name:PRYOR
Suffix:
Gender:F
Credentials:PHD,LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9904 OLD WARSON RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-1030
Mailing Address - Country:US
Mailing Address - Phone:314-853-6805
Mailing Address - Fax:314-909-9382
Practice Address - Street 1:7292 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63143-2438
Practice Address - Country:US
Practice Address - Phone:314-853-6805
Practice Address - Fax:314-909-9382
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004030704101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional