Healthcare Provider Details

I. General information

NPI: 1770607640
Provider Name (Legal Business Name): KRISTINA SUE TOTIN MSW,LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

153 BISON ST
WORTHINGTON PA
16262-2203
US

IV. Provider business mailing address

153 BISON ST
WORTHINGTON PA
16262-2203
US

V. Phone/Fax

Practice location:
  • Phone: 724-355-6566
  • Fax:
Mailing address:
  • Phone: 724-355-6566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW013054L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: