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General NPI Number Information
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NPI Number | 1104612472
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Entity Type | Individual
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Provider Name | CHRISTIAN ALFARO
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Gender | Male
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 115 5TH AVE S STE 301
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City | LA CROSSE
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State | WI
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Zip | 54601-4098
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Country | US
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Telephone | 608-785-0827
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Fax |
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Provider Business Mailing Address
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Address Line | 115 5TH AVE S STE 301
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City | LA CROSSE
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State | WI
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Zip | 54601-4098
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Country | US
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Telephone | 608-785-0827
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1151-228
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License Number State | WI
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