Healthcare Provider Details

I. General information

NPI: 1811490998
Provider Name (Legal Business Name): KRISTEN BIANCANIELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2018
Last Update Date: 03/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 E MCMURRAY RD STE B
MC MURRAY PA
15317-2948
US

IV. Provider business mailing address

1159 VALLEYVIEW DR
LAWRENCE PA
15055-1025
US

V. Phone/Fax

Practice location:
  • Phone: 412-439-1416
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: