Provider Demographics
NPI:1881087757
Name:GIROUARD, CHRISTINA TRIESTE (LAC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:TRIESTE
Last Name:GIROUARD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:POCASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02559-1905
Mailing Address - Country:US
Mailing Address - Phone:617-763-4992
Mailing Address - Fax:
Practice Address - Street 1:444 COUNTY RD
Practice Address - Street 2:
Practice Address - City:POCASSET
Practice Address - State:MA
Practice Address - Zip Code:02559-1905
Practice Address - Country:US
Practice Address - Phone:617-763-4992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-16
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA281862171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist