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General NPI Number Information
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NPI Number | 1285423053
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Entity Type | Organization
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Legal Business Name | OPEN STUDIO COOPERATIVE
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 502 W 7TH ST STE 100
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City | ERIE
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State | PA
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Zip | 16502-1333
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Country | US
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Telephone | 219-308-1076
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Fax |
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Provider Business Mailing Address
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Address Line | 502 W 7TH ST STE 100
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City | ERIE
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State | PA
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Zip | 16502-1333
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ART THERAPIST
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Name | KRISTOPHER WUEBBLING
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Credential | LPC, LPAT, ATR-BC
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Telephone | 219-308-1076
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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 |
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License Number State |
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