Healthcare Provider Details

I. General information

NPI: 1417225574
Provider Name (Legal Business Name): CHRISTINA MARIE KUCHCINSKI LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2011
Last Update Date: 12/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2375 GARDEN WAY
HERMITAGE PA
16148-5209
US

IV. Provider business mailing address

2375 GARDEN WAY
HERMITAGE PA
16148-5209
US

V. Phone/Fax

Practice location:
  • Phone: 724-983-5454
  • Fax: 724-983-5419
Mailing address:
  • Phone: 724-983-5454
  • Fax: 724-983-5419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW129163
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: