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General NPI Number Information
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NPI Number | 1992134993
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Entity Type | Individual
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Provider Name | KRISTIN VINCENZES PH.D., LPC, NCC, ACS
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Gender | Female
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Dates
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Enumeration Date | 11/11/2013
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Last Update Date | 02/27/2016
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Provider Practice Location Address
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Address Line | 393 ELDRED ST
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-2340
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Country | US
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Telephone | 717-818-5377
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Fax |
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Provider Business Mailing Address
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Address Line | 270 GREENFIELD DR
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City | MONTOURSVILLE
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State | PA
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Zip | 17754-6700
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Country | US
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Telephone | 717-818-5377
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC006759
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License Number State | PA
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