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General NPI Number Information
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NPI Number | 1376219048
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Entity Type | Individual
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Provider Name | MS. CHRISTINA STARR DENNIS
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Gender | Female
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Dates
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Enumeration Date | 08/21/2021
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Last Update Date | 08/21/2021
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Provider Practice Location Address
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Address Line | 520 KNOLLS DR UNIT 201
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-5763
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Country | US
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Telephone | 757-550-5242
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Fax |
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Provider Business Mailing Address
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Address Line | 520 KNOLLS DR UNIT 201
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City | NEWPORT NEWS
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State | VA
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Zip | 23602-5763
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Country | US
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Telephone | 757-550-5242
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0710103548
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License Number State | VA
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