| Doctor Name: | CRISTIE SEALEY ERVEN |
| NPI Number: | 1932143781 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | 2006006564 |
| Business Practice Address: | 204 N Poplar St Fair Play, MO - 656499298 |
| Business Phone Number: | 4178619448 |
| Business Fax Number: | |
| Mailing Address: | Po Box 145, FAIR PLAY |
| State: | MO |
| Postal Code: | 656490145 |
| Phone Number: | 4178619448 |
| Fax Number: | |
| NPI Enumeration Date: | 06/15/2006 |
| NPI Last Update Date: | 01/23/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2006006564 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |