Provider Demographics
NPI:1538214333
Name:MASSARI, CHRISTINA ANN (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:ANN
Last Name:MASSARI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 HIGHWAY 100 S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-2175
Mailing Address - Country:US
Mailing Address - Phone:952-915-4287
Mailing Address - Fax:
Practice Address - Street 1:3200 HIGHWAY 100 S
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2175
Practice Address - Country:US
Practice Address - Phone:952-915-4287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6582103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical