Provider Demographics
NPI:1457573636
Name:HANISH, CHRISTINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:
Last Name:HANISH
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 1:14300 N NORTHSIGHT BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3672
Mailing Address - Country:US
Mailing Address - Phone:602-918-7272
Mailing Address - Fax:480-991-3382
Practice Address - Street 1:14300 N NORTHSIGHT BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3672
Practice Address - Country:US
Practice Address - Phone:602-918-7272
Practice Address - Fax:480-991-3382
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3665103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist