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General NPI Number Information
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NPI Number | 1194517797
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Entity Type | Individual
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Provider Name | CHRISTOPHER ERIC PEARSON
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Gender | Male
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 4610 SALEM AVE
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City | TROTWOOD
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State | OH
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Zip | 45416
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Country | US
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Telephone | 937-219-4929
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Fax |
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Provider Business Mailing Address
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Address Line | 6748 SANDY DR
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City | TROTWOOD
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State | OH
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Zip | 45426-3141
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Country | US
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Telephone |
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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