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NPI Code Detail

MEDICARE: MRS. CHRISTIE JAN WIDGER LPC

MEDICARE:  MRS. CHRISTIE JAN WIDGER  LPC
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
1101YM0800XMental Health Counselor2442AL

General Provider Information

NPI Number : 1255516571
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CHRISTIE JAN WIDGER LPC
Provider Business Mailing Address
First Line : 558 BELVIEW DR
Second Line :
City : KILLEN
State : AL
Zip : 35645-7860
Country : US
Telephone Number : 256-757-3835
Fax Number :
Provider Business Practice Location Address
First Line : 475 PROVIDENCE MAIN ST NW
Second Line : SUITE 303A-B
City : HUNTSVILLE
State : AL
Zip : 35806-4815
Country : US
Telephone Number : 256-655-6762
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2008
Last Update Date : 01/05/2008

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Directions to “ MRS. CHRISTIE JAN WIDGER LPC” Practice Location

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