Provider Demographics
NPI:1679047138
Name:MCGHEE, CHRISTY DJADA
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:DJADA
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 S MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-4119
Mailing Address - Country:US
Mailing Address - Phone:318-307-5359
Mailing Address - Fax:
Practice Address - Street 1:113 S MAPLE ST
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-4119
Practice Address - Country:US
Practice Address - Phone:318-307-5359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor