Provider Demographics
NPI:1346646908
Name:RETHERFORD, CHRISTINA N (I1800918-SUPV)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:N
Last Name:RETHERFORD
Suffix:
Gender:F
Credentials:I1800918-SUPV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 W CENTRAL AVE STE 270
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-1103
Mailing Address - Country:US
Mailing Address - Phone:513-443-8914
Mailing Address - Fax:
Practice Address - Street 1:251 W CENTRAL AVE STE 270
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-1103
Practice Address - Country:US
Practice Address - Phone:513-443-8914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1800918-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical