Provider Demographics
NPI:1013520584
Name:KLINETOBE, CHRISTY M (LAC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:M
Last Name:KLINETOBE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6231 E 33RD ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-6840
Mailing Address - Country:US
Mailing Address - Phone:520-304-0065
Mailing Address - Fax:
Practice Address - Street 1:1014 N COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-4239
Practice Address - Country:US
Practice Address - Phone:520-303-1697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-6665T101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor