Provider Demographics
NPI:1316401292
Name:CISNEROS, CRISTINA (PSYCHOLOGY MASTER)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:CISNEROS
Suffix:
Gender:F
Credentials:PSYCHOLOGY MASTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-2802
Mailing Address - Country:US
Mailing Address - Phone:610-200-5121
Mailing Address - Fax:267-712-2729
Practice Address - Street 1:530 N 7TH ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102-2802
Practice Address - Country:US
Practice Address - Phone:610-200-5121
Practice Address - Fax:267-712-2729
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health