Provider Demographics
NPI:1780725838
Name:HUBER, CHRISTINE (LICSW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:HUBER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 EDWARD ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2303
Mailing Address - Country:US
Mailing Address - Phone:781-828-3533
Mailing Address - Fax:781-828-2471
Practice Address - Street 1:7 RIDGEFIELD RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:MA
Practice Address - Zip Code:01890-3917
Practice Address - Country:US
Practice Address - Phone:781-729-6904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA105357104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker