Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | PC007386 | PA |
N | 101YS0200X | School Counselor | 4280748 | PA |
NPI | 1114347721 |
---|---|
Provider Name | Nick Christy |
First Address | Glenshaw, PA 15116-1425 |
Second Address | Glenshaw, PA 15116-1425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2014 |
Last Update Date | 22/04/2014 |