Basic Information
| Provider Information | |||||||||
| NPI: | 1184922106 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TRASK | ||||||||
| FirstName: | CHRISTY | ||||||||
| MiddleName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 6500 S MOONEY BLVD UNIT B | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932779535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596851200 | ||||||||
| FaxNumber: | 5596859742 | ||||||||
| Practice Location | |||||||||
| Address1: | 6500 S MOONEY BLVD UNIT B | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932779535 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596851200 | ||||||||
| FaxNumber: | 5596859742 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2011 | ||||||||
| LastUpdateDate: | 03/01/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.