Provider Demographics
NPI:1043351323
Name:DURHAM, CHRISTINA J (PHD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:J
Last Name:DURHAM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 NORTH 300 WEST,
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ST. GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770
Mailing Address - Country:US
Mailing Address - Phone:435-688-9471
Mailing Address - Fax:435-688-9478
Practice Address - Street 1:166 N 300 W
Practice Address - Street 2:SUITE 1
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-2770
Practice Address - Country:US
Practice Address - Phone:435-688-9471
Practice Address - Fax:435-688-9478
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT378171-2501103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical