Provider Demographics
NPI:1154726156
Name:DAY, CHRISTINE
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 RUDY LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-1205
Mailing Address - Country:US
Mailing Address - Phone:317-508-1906
Mailing Address - Fax:
Practice Address - Street 1:4010 DUPONT CIR STE 228
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4825
Practice Address - Country:US
Practice Address - Phone:317-508-1906
Practice Address - Fax:502-384-0478
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014038562101Y00000X
KY173163101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor