Provider Demographics
NPI:1215369889
Name:BAIR, CHRISTINA DAWN (LSW)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:DAWN
Last Name:BAIR
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 E FIRST AVE
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355
Mailing Address - Country:US
Mailing Address - Phone:314-323-5461
Mailing Address - Fax:
Practice Address - Street 1:220 W GAY ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2917
Practice Address - Country:US
Practice Address - Phone:610-764-8655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1274401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical