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General NPI Number Information
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NPI Number | 1558760645
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Entity Type | Organization
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Legal Business Name | KRISTIN MCCONNELL LLC
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 438 S MAIN ST 2ND FLOOR
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City | PITTSBURGH
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State | PA
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Zip | 15220-5541
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Country | US
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Telephone | 614-804-4806
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Fax |
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Provider Business Mailing Address
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Address Line | 1222 DRIFTWOOD DR
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City | PITTSBURGH
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State | PA
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Zip | 15243-1737
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Country | US
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Telephone | 614-804-4806
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | KRISTIN CORNELL
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Credential | LPC
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Telephone | 614-804-4806
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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 | PC007679
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License Number State | PA
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