Provider Demographics
NPI:1144528191
Name:LILLYWHITE, CHRISTINE (MS, MT-BC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LILLYWHITE
Suffix:
Gender:F
Credentials:MS, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6922 E LOMITA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-6602
Mailing Address - Country:US
Mailing Address - Phone:480-290-3071
Mailing Address - Fax:
Practice Address - Street 1:6922 E LOMITA AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-6602
Practice Address - Country:US
Practice Address - Phone:480-290-3071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist