Provider Demographics
NPI:1356553762
Name:MAYHALL, CHRISTINE ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ANN
Last Name:MAYHALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3526 PAPE AVENUE
Mailing Address - Street 2:#1
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1734
Mailing Address - Country:US
Mailing Address - Phone:513-477-6365
Mailing Address - Fax:
Practice Address - Street 1:3526 PAPE AVENUE #1
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-1734
Practice Address - Country:US
Practice Address - Phone:513-477-6365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4916103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical