Provider Demographics
NPI:1245811942
Name:NAVARRO, CHRIS JEANNETTE (MA)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:JEANNETTE
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:JEANNETTE
Other - Last Name:NAVARRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:P.O. BOX 110
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983
Mailing Address - Country:US
Mailing Address - Phone:787-940-3679
Mailing Address - Fax:
Practice Address - Street 1:EXPRESO TRUJILLO ALTO PR-181 CARRETER846
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00926
Practice Address - Country:US
Practice Address - Phone:787-961-0320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
6093103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
6093OtherPRIVADO