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General NPI Number Information
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NPI Number | 1639595259
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Entity Type | Individual
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Provider Name | MICHAEL KREIDLER MFT
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Gender | Male
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Dates
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Enumeration Date | 03/06/2014
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 189 MARKET ST
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City | KINGSTON
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State | PA
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Zip | 18704-5400
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Country | US
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Telephone | 570-961-3361
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Fax | 570-961-3364
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Provider Business Mailing Address
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Address Line | 797 MAIN ST
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City | SUGAR NOTCH
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State | PA
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Zip | 18706-2019
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Country | US
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Telephone | 570-589-0140
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MF000769
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License Number State | PA
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