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General NPI Number Information
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NPI Number | 1669033221
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Entity Type | Individual
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Provider Name | CHRISTIN ANN BUCCIERO
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Gender | Female
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 01/26/2021
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Provider Practice Location Address
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Address Line | 300 NORTHVIEW DR
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City | EPHRATA
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State | PA
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Zip | 17522-9556
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Country | US
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Telephone | 568-905-0032
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Fax |
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Provider Business Mailing Address
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Address Line | 31 ALEXANDER CT
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City | VOORHEES
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State | NJ
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Zip | 08043-2115
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Country | US
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Telephone | 856-905-0032
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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 | MF001073
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License Number State | PA
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