Healthcare Provider Details

I. General information

NPI: 1568159671
Provider Name (Legal Business Name): CHRISTINA DANIELLE O'BRIEN MA, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2023
Last Update Date: 12/29/2023
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

397 EAGLEVIEW BLVD STE 120
EXTON PA
19341-1150
US

IV. Provider business mailing address

317 ROBINSON ST
COCHRANVILLE PA
19330-9409
US

V. Phone/Fax

Practice location:
  • Phone: 610-422-3064
  • Fax:
Mailing address:
  • Phone: 610-701-1107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC014504
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number11583
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: