Provider Demographics
NPI:1174764898
Name:FERNANDEZ, CHRISTIE JUAWICE (LPC-I)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:JUAWICE
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2807 KINGS CROSSING DR
Mailing Address - Street 2:STE. 122
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-5450
Mailing Address - Country:US
Mailing Address - Phone:832-233-2086
Mailing Address - Fax:
Practice Address - Street 1:2807 KINGS CROSSING DR
Practice Address - Street 2:STE. 122
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77345-5450
Practice Address - Country:US
Practice Address - Phone:832-233-2086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health