Provider Demographics
NPI:1699800706
Name:MCKILLIP, CHRISTINA (PC)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:MCKILLIP
Suffix:
Gender:F
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6402 E MAIN ST STE 103
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-2356
Mailing Address - Country:US
Mailing Address - Phone:614-559-2800
Mailing Address - Fax:614-559-2801
Practice Address - Street 1:6402 E MAIN ST STE 103
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-2356
Practice Address - Country:US
Practice Address - Phone:614-559-2800
Practice Address - Fax:614-559-2801
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC-0007212101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health