Provider Demographics
NPI:1467955823
Name:CZMIEL, FAITH DANIELLE
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:DANIELLE
Last Name:CZMIEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FAITH
Other - Middle Name:DANIELLE
Other - Last Name:CROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:586 BEHM RD
Mailing Address - Street 2:
Mailing Address - City:WIND RIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15380-1264
Mailing Address - Country:US
Mailing Address - Phone:724-747-7107
Mailing Address - Fax:
Practice Address - Street 1:51 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WAYNESBURG
Practice Address - State:PA
Practice Address - Zip Code:15370-1258
Practice Address - Country:US
Practice Address - Phone:724-747-7107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2019-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA2255A2300X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer