Provider Demographics
NPI:1902056146
Name:HOFF GUPTA, CHRISTINA (MC, PC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:HOFF GUPTA
Suffix:
Gender:F
Credentials:MC, PC
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:HOFF VELLTURO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MC, PC
Mailing Address - Street 1:7596 ESTATE AVE
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-5369
Mailing Address - Country:US
Mailing Address - Phone:216-712-2012
Mailing Address - Fax:
Practice Address - Street 1:7596 ESTATE AVE
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-5369
Practice Address - Country:US
Practice Address - Phone:216-712-2012
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0600157101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health