Provider Demographics
NPI:1144584194
Name:MCMENAMY, CHRISTINE (MS ED)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:
Last Name:MCMENAMY
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13201 SHERBURNE CIR APT 103
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-1404
Mailing Address - Country:US
Mailing Address - Phone:516-241-4345
Mailing Address - Fax:
Practice Address - Street 1:13201 SHERBURNE CIR APT 103
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-1404
Practice Address - Country:US
Practice Address - Phone:516-241-4345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-25
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician