MEDICARE: CHRISTINA STOKES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1104394543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA STOKES

Provider Business Mailing Address
First Line	:	107 FANNIN AVE # 200
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-5218
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 FANNIN AVE # 200
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-5218
Country	:	US
Telephone Number	:	325-261-9272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2018
Last Update Date	:	11/04/2018

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Directions to “ CHRISTINA STOKES ” Practice Location

Language	Start Address	Practice Location

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