Provider Demographics
NPI:1215501143
Name:CURTIS, CHRISTOPHER BRYAN (EDD)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:BRYAN
Last Name:CURTIS
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11361 CEDAR BEND DR
Mailing Address - Street 2:
Mailing Address - City:PINCKNEY
Mailing Address - State:MI
Mailing Address - Zip Code:48169-9539
Mailing Address - Country:US
Mailing Address - Phone:734-368-6183
Mailing Address - Fax:
Practice Address - Street 1:11361 CEDAR BEND DR
Practice Address - Street 2:
Practice Address - City:PINCKNEY
Practice Address - State:MI
Practice Address - Zip Code:48169-9539
Practice Address - Country:US
Practice Address - Phone:734-368-6183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-15
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007418101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional