Provider Demographics
NPI:1912958604
Name:DEMARY, CHRISTINA REBECCA (MA)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:REBECCA
Last Name:DEMARY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:323 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144
Mailing Address - Country:US
Mailing Address - Phone:704-639-1616
Mailing Address - Fax:704-639-1699
Practice Address - Street 1:121 W COUNCIL ST
Practice Address - Street 2:SUITE 301
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-4357
Practice Address - Country:US
Practice Address - Phone:704-639-1616
Practice Address - Fax:704-639-1699
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-15
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-080-135101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC133J8OtherBCBS