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General NPI Number Information
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NPI Number | 1336227446
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Entity Type | Individual
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Provider Name | CHRISTINA LYNN PRISTASH M.S., LMFT
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Gender | Female
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1700 N BROADWAY STE 118
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City | ROCHESTER
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State | MN
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Zip | 55906-4144
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Country | US
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Telephone | 507-202-0701
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Fax |
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Provider Business Mailing Address
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Address Line | 1076 BUSH CT SW
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City | EYOTA
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State | MN
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Zip | 55934-3106
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Country | US
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Telephone | 507-202-0701
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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 | 1293
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License Number State | MN
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