Provider Demographics
NPI:1447463906
Name:STINSON, CHRISTINE P (MA)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:P
Last Name:STINSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 YUCATAN DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-2922
Mailing Address - Country:US
Mailing Address - Phone:401-738-7388
Mailing Address - Fax:401-738-7388
Practice Address - Street 1:28 YUCATAN DR
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02889-2922
Practice Address - Country:US
Practice Address - Phone:401-738-7388
Practice Address - Fax:401-738-7388
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRIMHC 00029101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI11642560OtherCAQH