MEDICARE: MISS SARA KRISTEN KUNTZ L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC007107	PA

General Provider Information

NPI Number	:	1760817951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SARA KRISTEN KUNTZ L.P.C.

Provider Business Mailing Address
First Line	:	841 W 50TH ST
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16509-2513
Country	:	US
Telephone Number	:	724-771-4410
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 W 21ST ST
Second Line	:	SUITE 3
City	:	ERIE
State	:	PA
Zip	:	16506-2972
Country	:	US
Telephone Number	:	724-771-4410
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/06/2013
Last Update Date	:	12/15/2015

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Directions to “ MISS SARA KRISTEN KUNTZ L.P.C.” Practice Location

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