Doctor Name: | MRS. CHRISTINE M PADA |
NPI Number: | 1104242528 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CRC, CVRT, LPC |
License Number: | 5400-125 |
Business Practice Address: | 1110 10th Ave Ste L4 Menominee, MI - 498583058 |
Business Phone Number: | 9062902444 |
Business Fax Number: | |
Mailing Address: | 1110 10th Ave, Suite L4 MENOMINEE |
State: | MI |
Postal Code: | 498583058 |
Phone Number: | 9062902444 |
Fax Number: | |
NPI Enumeration Date: | 03/10/2014 |
NPI Last Update Date: | 07/19/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 5400-125 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |