Provider Demographics
NPI:1952071060
Name:BURTON, CHRISTINA LYN (MA CAS)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LYN
Last Name:BURTON
Suffix:
Gender:F
Credentials:MA CAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1508 AVIEMORE PL
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5713
Mailing Address - Country:US
Mailing Address - Phone:410-960-1985
Mailing Address - Fax:
Practice Address - Street 1:120 SISTER PIERRE DR STE 403
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7536
Practice Address - Country:US
Practice Address - Phone:410-823-6408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool