Provider Demographics
NPI:1700771136
Name:PRESTIGIACOMO, CHRISTIANA (PHD)
Entity type:Individual
Prefix:
First Name:CHRISTIANA
Middle Name:
Last Name:PRESTIGIACOMO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3061 SIGNATURE BLVD APT L
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-6482
Mailing Address - Country:US
Mailing Address - Phone:573-424-3051
Mailing Address - Fax:
Practice Address - Street 1:7616 CURRELL BLVD STE 170
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2297
Practice Address - Country:US
Practice Address - Phone:651-505-3273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool