Healthcare Provider Details

I. General information

NPI: 1174984868
Provider Name (Legal Business Name): CHRISTOPHER ZILLA LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2016
Last Update Date: 03/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

543 FRANKLIN HILL RD
KITTANNING PA
16201-8921
US

IV. Provider business mailing address

813 PONY FARM RD
KITTANNING PA
16201-4731
US

V. Phone/Fax

Practice location:
  • Phone: 724-543-1888
  • Fax:
Mailing address:
  • Phone: 724-543-1888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC008720
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: