Healthcare Provider Details

I. General information

NPI: 1831428580
Provider Name (Legal Business Name): M CRISTINA MACHIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CRISTINA MACHIN MS ED

II. Dates (important events)

Enumeration Date: 12/09/2009
Last Update Date: 12/12/2022
Certification Date: 12/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30599 SUSSEX HWY STE 3
LAUREL DE
19956-4417
US

IV. Provider business mailing address

PO BOX 70
DELMAR DE
19940-0070
US

V. Phone/Fax

Practice location:
  • Phone: 302-497-4491
  • Fax:
Mailing address:
  • Phone: 443-880-8778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC1727
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC-488
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: