Healthcare Provider Details

I. General information

NPI: 1427405125
Provider Name (Legal Business Name): CHRISTI FLYNN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2016
Last Update Date: 05/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BELL ST
ELKINS WV
26241-3701
US

IV. Provider business mailing address

100 BELL ST
ELKINS WV
26241-3701
US

V. Phone/Fax

Practice location:
  • Phone: 304-637-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1632
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: