Provider Demographics
NPI:1184283301
Name:CHRISTIAN, CHANTAL (MS, CGC)
Entity type:Individual
Prefix:
First Name:CHANTAL
Middle Name:
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:CJ
Other - Middle Name:
Other - Last Name:CHRISTIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CGC
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-955-6709
Mailing Address - Fax:414-955-0158
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-955-6709
Practice Address - Fax:414-955-0158
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS