Doctor Name: | CHRISTOPHER LAWRENCE MENARD |
NPI Number: | 1033359278 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PSY.D. |
License Number: | 071007632 |
Business Practice Address: | 505 E Green St Suite 329 Champaign, IL - 618205723 |
Business Phone Number: | 2173330041 |
Business Fax Number: | 2173330064 |
Mailing Address: | 505 E Green St, Suite 329 CHAMPAIGN |
State: | IL |
Postal Code: | 618205723 |
Phone Number: | 2173330041 |
Fax Number: | 2173330064 |
NPI Enumeration Date: | 02/28/2009 |
NPI Last Update Date: | 02/28/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 071007632 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |