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General NPI Number Information
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NPI Number | 1144645078
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Entity Type | Individual
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Provider Name | CHRISTINE KALIE LPC
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Gender | Female
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Dates
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Enumeration Date | 03/01/2014
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Last Update Date | 03/01/2014
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Provider Practice Location Address
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Address Line | 1371 W 6TH ST
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City | ERIE
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State | PA
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Zip | 16505-2503
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Country | US
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Telephone | 814-464-3958
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Fax | 814-725-0707
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Provider Business Mailing Address
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Address Line | 6032 PINE VALLEY LN
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City | FAIRVIEW
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State | PA
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Zip | 16415-3272
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Country | US
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Telephone | 814-464-3958
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Fax | 814-725-0707
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC007075
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License Number State | PA
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