Provider Demographics
NPI:1003261157
Name:DAUDIER, CHRISTINE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:DAUDIER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 W CULLUMBER AVE APT 3007
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-4912
Mailing Address - Country:US
Mailing Address - Phone:845-527-6019
Mailing Address - Fax:
Practice Address - Street 1:10046 N METRO PKWY W
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-1437
Practice Address - Country:US
Practice Address - Phone:844-646-3247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-26
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY090271-1104100000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker