Provider Demographics
NPI:1295047157
Name:BROWN, CHRISTA
Entity type:Individual
Prefix:
First Name:CHRISTA
Middle Name:
Last Name:BROWN
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 1:3140 W. BRITTAN RD,.
Mailing Address - Street 2:SUITE #200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-6754
Mailing Address - Country:US
Mailing Address - Phone:405-206-9921
Mailing Address - Fax:
Practice Address - Street 1:3140 W BRITTON RD
Practice Address - Street 2:SUITE #200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-2074
Practice Address - Country:US
Practice Address - Phone:405-206-9921
Practice Address - Fax:405-607-1339
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health