Basic Information
| Provider Information | |||||||||
| NPI: | 1154361236 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAWTON | ||||||||
| FirstName: | CHRISTINA | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | CSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 47763 MEADOWBROOK DR | ||||||||
| Address2: | |||||||||
| City: | MACOMB TWP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480442756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567095799 | ||||||||
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| Practice Location | |||||||||
| Address1: | 279 N GROESBECK HWY | ||||||||
| Address2: | |||||||||
| City: | MOUNT CLEMENS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480431546 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5866270024 | ||||||||
| FaxNumber: | 5866270027 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 10/11/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 6801077424 | MI | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.