Provider Demographics
NPI:1194029868
Name:AGUILAR, CHRISTINE MARIE (LMFT)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3067 S 9TH PL
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-3949
Mailing Address - Country:US
Mailing Address - Phone:414-218-6199
Mailing Address - Fax:414-247-0816
Practice Address - Street 1:1730 W FLORIST AVE SUITE 125
Practice Address - Street 2:SEBASTIAN FAMILY PSYCHOLOGY PRACTICE LLC
Practice Address - City:GLENDALE
Practice Address - State:WI
Practice Address - Zip Code:53209-3800
Practice Address - Country:US
Practice Address - Phone:414-247-0801
Practice Address - Fax:414-247-0816
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI643-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40945500Medicaid