Provider Demographics
NPI:1699093930
Name:CRISTIANO, MARY HEALY (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:HEALY
Last Name:CRISTIANO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:CATHERINE
Other - Last Name:HEALY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:26 CHESTNUT ST
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-6149
Mailing Address - Country:US
Mailing Address - Phone:978-749-2700
Mailing Address - Fax:
Practice Address - Street 1:26 CHESTNUT ST
Practice Address - Street 2:SUITE 2E
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-6149
Practice Address - Country:US
Practice Address - Phone:978-749-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool