Provider Demographics
NPI:1124277306
Name:NOWAK, CHRISTINE M (PCC)
Entity type:Individual
Prefix:MISS
First Name:CHRISTINE
Middle Name:M
Last Name:NOWAK
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15985 EAST HIGH ST.
Mailing Address - Street 2:SUITE 206
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44062
Mailing Address - Country:US
Mailing Address - Phone:440-632-0332
Mailing Address - Fax:440-477-2656
Practice Address - Street 1:15985 EAST HIGH ST.
Practice Address - Street 2:SUITE 206
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062
Practice Address - Country:US
Practice Address - Phone:440-632-0332
Practice Address - Fax:440-477-2656
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.0500327101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional