Provider Demographics
NPI:1356401418
Name:DEVITA, CHRISTINA JEAN (LPC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:JEAN
Last Name:DEVITA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:JEAN
Other - Last Name:GAULTIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4234 N WINFIELD SCOTT PLZ
Mailing Address - Street 2:STE 110
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3944
Mailing Address - Country:US
Mailing Address - Phone:480-970-8070
Mailing Address - Fax:
Practice Address - Street 1:4234 N WINFIELD SCOTT PLZ
Practice Address - Street 2:STE 110
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3944
Practice Address - Country:US
Practice Address - Phone:480-970-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ LPC 1956101Y00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist