MEDICARE: CRISTIANA WHITE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	CW010484L	PA

General Provider Information

NPI Number	:	1982050977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTIANA WHITE

Provider Business Mailing Address
First Line	:	125 EMERYVILLE DR
Second Line	:	SUITE 230
City	:	CRANBERRY TWP
State	:	PA
Zip	:	16066-5020
Country	:	US
Telephone Number	:	724-609-5002
Fax Number	:	724-299-8964

Provider Business Practice Location Address
First Line	:	125 EMERYVILLE DR
Second Line	:	SUITE 230
City	:	CRANBERRY TWP
State	:	PA
Zip	:	16066-5020
Country	:	US
Telephone Number	:	724-609-5002
Fax Number	:	724-299-8964

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/09/2016
Last Update Date	:	05/09/2016

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Directions to “ CRISTIANA WHITE ” Practice Location

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