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General NPI Number Information
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NPI Number | 1710349428
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Entity Type | Organization
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Legal Business Name | CHRISTINE KALIE, LCC
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 2233 EBCO DR
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City | ERIE
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State | PA
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Zip | 16506-6919
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Country | US
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Telephone | 814-464-3958
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Fax | 814-725-0707
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Provider Business Mailing Address
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Address Line | 2233 EBCO DR
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City | ERIE
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State | PA
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Zip | 16506-6919
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Country | US
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Telephone | 814-464-3958
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Fax | 814-725-0707
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINE KALIE
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Credential | LPC
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Telephone | 814-464-3958
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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 | PC007075
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License Number State | PA
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