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NPI Code Detail

MEDICARE: CHRISTIE MICHELLE AVERY

MEDICARE: CHRISTIE MICHELLE AVERY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1245746726
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIE MICHELLE AVERY
Provider Business Mailing Address
First Line : 155 BIMINI PL
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-5902
Country : US
Telephone Number : 121-338-8542
Fax Number :
Provider Business Practice Location Address
First Line : 155 BIMINI PL
Second Line :
City : LOS ANGELES
State : CA
Zip : 90004-5902
Country : US
Telephone Number : 213-388-5423
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2017
Last Update Date : 12/20/2017

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Directions to “ CHRISTIE MICHELLE AVERY ” Practice Location

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