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NPI Code Detail

MEDICARE: CHRISTINA ANN GERARD

MEDICARE: CHRISTINA ANN GERARD
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1639893225
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA ANN GERARD
Provider Business Mailing Address
First Line : 116 WENONAH DR
Second Line :
City : PONTIAC
State : MI
Zip : 48341-1956
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 51111 WOODWARD AVE STE 150
Second Line :
City : PONTIAC
State : MI
Zip : 48342-5037
Country : US
Telephone Number : 248-977-5310
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2022
Last Update Date : 09/28/2022

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Directions to “ CHRISTINA ANN GERARD ” Practice Location

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