Provider Demographics
NPI:1881905065
Name:DENIAL, CHRISTYN S
Entity type:Individual
Prefix:MRS
First Name:CHRISTYN
Middle Name:S
Last Name:DENIAL
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:PO BOX 8
Mailing Address - Street 2:PICKETTS CORNERS ROAD
Mailing Address - City:SARANAC
Mailing Address - State:NY
Mailing Address - Zip Code:12981-0008
Mailing Address - Country:US
Mailing Address - Phone:518-565-5900
Mailing Address - Fax:
Practice Address - Street 1:18 PICKETTS CORNERS ROAD
Practice Address - Street 2:
Practice Address - City:SARANAC
Practice Address - State:NY
Practice Address - Zip Code:12981-0008
Practice Address - Country:US
Practice Address - Phone:518-565-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1332572103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool