Provider Demographics
NPI:1649962879
Name:EMRICH, CRISTINA SANDA (DO)
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:SANDA
Last Name:EMRICH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 GALLOP LN
Mailing Address - Street 2:
Mailing Address - City:BRISTOW
Mailing Address - State:VA
Mailing Address - Zip Code:20136-1801
Mailing Address - Country:US
Mailing Address - Phone:803-236-6208
Mailing Address - Fax:
Practice Address - Street 1:10801 GALLOP LN
Practice Address - Street 2:
Practice Address - City:BRISTOW
Practice Address - State:VA
Practice Address - Zip Code:20136-1801
Practice Address - Country:US
Practice Address - Phone:803-236-6208
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC200001441101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional