Healthcare Provider Details

I. General information

NPI: 1376027987
Provider Name (Legal Business Name): CHRISTINA SEXTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2018
Last Update Date: 09/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 LEXINGTON RD
RICHMOND KY
40475-7923
US

IV. Provider business mailing address

2607 BATTLEFIELD MEMORIAL HWY
BEREA KY
40403-8331
US

V. Phone/Fax

Practice location:
  • Phone: 859-893-0729
  • Fax:
Mailing address:
  • Phone: 859-893-0729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number242761
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: