Provider Demographics
NPI:1114113735
Name:BRUCE, CHRISTINE KA (MDIV, MCAT, LMFT)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:KA
Last Name:BRUCE
Suffix:
Gender:F
Credentials:MDIV, MCAT, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 MOREDON RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-7705
Mailing Address - Country:US
Mailing Address - Phone:215-938-1130
Mailing Address - Fax:215-914-4197
Practice Address - Street 1:521 MOREDON RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-7705
Practice Address - Country:US
Practice Address - Phone:215-938-1130
Practice Address - Fax:215-914-4197
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000174106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist