Provider Demographics
NPI:1669199519
Name:BUTLER, CHRISTINA RENEE
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:RENEE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6112 86TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-2846
Mailing Address - Country:US
Mailing Address - Phone:240-515-3571
Mailing Address - Fax:
Practice Address - Street 1:6112 86TH AVE
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-2846
Practice Address - Country:US
Practice Address - Phone:240-515-3571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach