Provider Demographics
NPI:1932126539
Name:MASON, CHRISTINE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ANN
Last Name:MASON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:3393 IRIS AVENUE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1956
Mailing Address - Country:US
Mailing Address - Phone:303-886-6307
Mailing Address - Fax:303-449-6825
Practice Address - Street 1:3393 IRIS AVENUE
Practice Address - Street 2:SUITE 106
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1956
Practice Address - Country:US
Practice Address - Phone:303-886-6307
Practice Address - Fax:303-449-6825
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2677103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist