Provider Demographics
NPI:1215240189
Name:FALE, CHRISTINE MARRIE (BS, CACIII)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARRIE
Last Name:FALE
Suffix:
Gender:F
Credentials:BS, CACIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6949 HIGHWAY 73
Mailing Address - Street 2:# L-3
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-6200
Mailing Address - Country:US
Mailing Address - Phone:303-674-7004
Mailing Address - Fax:
Practice Address - Street 1:6949 HIGHWAY 73
Practice Address - Street 2:# L-3
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-6200
Practice Address - Country:US
Practice Address - Phone:303-674-7004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC-6708101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)