Provider Demographics
NPI:1861631608
Name:CHRISTIAN, MARIE LYNN (CMT)
Entity type:Individual
Prefix:MISS
First Name:MARIE
Middle Name:LYNN
Last Name:CHRISTIAN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 E WASHINGTON AVE
Mailing Address - Street 2:UNIT181
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-5684
Mailing Address - Country:US
Mailing Address - Phone:956-244-5541
Mailing Address - Fax:956-365-3113
Practice Address - Street 1:1327 E WASHINGTON AVE
Practice Address - Street 2:UNIT181
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-5684
Practice Address - Country:US
Practice Address - Phone:956-244-5541
Practice Address - Fax:956-365-3113
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT107786225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist