Provider Demographics
NPI:1932328499
Name:BIEDERMANN, CHRISTINA LOUISE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:LOUISE
Last Name:BIEDERMANN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:CHRISTINA
Other - Middle Name:BIEDERMANN
Other - Last Name:COULOMBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:25 MAIN STREET
Mailing Address - Street 2:STOCKBRIDGE
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01262
Mailing Address - Country:US
Mailing Address - Phone:413-931-5239
Mailing Address - Fax:
Practice Address - Street 1:25 MAIN STREET
Practice Address - Street 2:STOCKBRIDGE
Practice Address - City:STOCKBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01262
Practice Address - Country:US
Practice Address - Phone:413-931-5239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8851103TC0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program