Provider Demographics
NPI:1881374064
Name:PHAM, CHRISTIE SIDORA
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:SIDORA
Last Name:PHAM
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 1:200 QUINN DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15275-1055
Mailing Address - Country:US
Mailing Address - Phone:412-362-8677
Mailing Address - Fax:
Practice Address - Street 1:200 QUINN DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275-1055
Practice Address - Country:US
Practice Address - Phone:412-362-8677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health