Provider Demographics
NPI:1003538380
Name:BLOSL, KRISTI LEIGH (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:LEIGH
Last Name:BLOSL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:LEIGH
Other - Last Name:WESOLOWSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:103 COLONIAL WAY
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-1424
Mailing Address - Country:US
Mailing Address - Phone:724-494-0908
Mailing Address - Fax:
Practice Address - Street 1:3428 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-3132
Practice Address - Country:US
Practice Address - Phone:724-728-6670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0209831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical