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General NPI Number Information
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NPI Number | 1629405667
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Entity Type | Organization
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Legal Business Name | KRISTEN L. VERDELLI, MS, LPC: CANINE ASSISTED PSYCHOTHERAPY
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Dates
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Enumeration Date | 10/04/2013
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Last Update Date | 10/04/2013
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Provider Practice Location Address
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Address Line | 160 S PROGRESS AVE SUITE 1C
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City | HARRISBURG
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State | PA
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Zip | 17109-4636
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Country | US
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Telephone | 717-885-2712
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Fax | 717-885-2719
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Provider Business Mailing Address
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Address Line | 160 S PROGRESS AVE SUITE 1C
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City | HARRISBURG
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State | PA
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Zip | 17109-4636
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Country | US
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Telephone | 717-885-2712
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Fax | 717-885-2719
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Authorized Official
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Title or Position | OWNER
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Name | KRISTEN L VERDELLI
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Credential | MS, LPC
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Telephone | 717-885-2712
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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 | PC007109
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License Number State | PA
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