Healthcare Provider Details

I. General information

NPI: 1205071230
Provider Name (Legal Business Name): CHRISTINE ANNE ROUTHIER LMHC, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2008
Last Update Date: 12/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 MOUNT AUBURN ST
WATERTOWN MA
02472-3992
US

IV. Provider business mailing address

11 MAGNOLIA AVE
MANCHESTER MA
01944-1607
US

V. Phone/Fax

Practice location:
  • Phone: 978-500-2992
  • Fax:
Mailing address:
  • Phone: 978-525-3990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number3721
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: