Provider Demographics
NPI:1942717178
Name:MCINNES, CRISTINA MARIE
Entity Type:Individual
Prefix:MRS
First Name:CRISTINA
Middle Name:MARIE
Last Name:MCINNES
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CRISTINA
Other - Middle Name:
Other - Last Name:BEAULIEU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4407 S AGAVE AVE
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-6395
Mailing Address - Country:US
Mailing Address - Phone:928-257-2899
Mailing Address - Fax:
Practice Address - Street 1:1020 S 4TH AVE STE 214
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-3800
Practice Address - Country:US
Practice Address - Phone:928-224-2925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-09
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health