Provider Demographics
NPI:1306845300
Name:MARBACH, CHRISTINA ROSE (LPC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ROSE
Last Name:MARBACH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19315 FM 2252
Mailing Address - Street 2:SUITE 156
Mailing Address - City:GARDEN RIDGE
Mailing Address - State:TX
Mailing Address - Zip Code:78266-2552
Mailing Address - Country:US
Mailing Address - Phone:210-651-3475
Mailing Address - Fax:210-651-3471
Practice Address - Street 1:19315 FM 2252
Practice Address - Street 2:SUITE 156
Practice Address - City:GARDEN RIDGE
Practice Address - State:TX
Practice Address - Zip Code:78266-2552
Practice Address - Country:US
Practice Address - Phone:210-651-3475
Practice Address - Fax:210-651-3471
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15811101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional