Provider Demographics
NPI:1003165655
Name:MYERS, CHRISTINE MARIE (MA)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:MARIE
Last Name:MYERS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:HOETZLEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1370 WASHINGTON PIKE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-2862
Mailing Address - Country:US
Mailing Address - Phone:412-621-3777
Mailing Address - Fax:412-622-7595
Practice Address - Street 1:275 CURRY HOLLOW RD
Practice Address - Street 2:SUITE 205
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-4631
Practice Address - Country:US
Practice Address - Phone:412-621-3777
Practice Address - Fax:412-622-7595
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000678106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist