Provider Demographics
NPI:1376722678
Name:BEARDMORE, CHRISTINE (MA, MFCC,DDIV)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:BEARDMORE
Suffix:
Gender:F
Credentials:MA, MFCC,DDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 504
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-0504
Mailing Address - Country:US
Mailing Address - Phone:215-527-4791
Mailing Address - Fax:
Practice Address - Street 1:1464 HUNTER RD
Practice Address - Street 2:
Practice Address - City:RYDAL
Practice Address - State:PA
Practice Address - Zip Code:19046-1215
Practice Address - Country:US
Practice Address - Phone:215-527-4791
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000235106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist