Provider Demographics
NPI:1497167761
Name:CRISTAUDO, KATHARINE LANE (MSW)
Entity Type:Individual
Prefix:MS
First Name:KATHARINE
Middle Name:LANE
Last Name:CRISTAUDO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 LANCASTER AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-5200
Mailing Address - Country:US
Mailing Address - Phone:302-888-2233
Mailing Address - Fax:
Practice Address - Street 1:2800 LANCASTER AVE STE 6
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-5200
Practice Address - Country:US
Practice Address - Phone:302-888-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker