Provider Demographics
NPI:1184897241
Name:THOMAS, CHRISTINA HALLAGER
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:HALLAGER
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 N ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-2706
Mailing Address - Country:US
Mailing Address - Phone:919-818-0018
Mailing Address - Fax:
Practice Address - Street 1:1306 N ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-2706
Practice Address - Country:US
Practice Address - Phone:919-818-0018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4384101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor