Provider Demographics
NPI:1457807166
Name:BROWN, CHRISTINA M (CADC-INTERN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:CADC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 DAVIDSON WAY
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3144
Mailing Address - Country:US
Mailing Address - Phone:775-329-9830
Mailing Address - Fax:775-329-9830
Practice Address - Street 1:1015 N. SIERRA ST.
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-3722
Practice Address - Country:US
Practice Address - Phone:775-329-9830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV02023-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)