Provider Demographics
NPI:1518226109
Name:LALLI, TRISTA MARIE
Entity Type:Individual
Prefix:
First Name:TRISTA
Middle Name:MARIE
Last Name:LALLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:PA
Mailing Address - Zip Code:16686-1602
Mailing Address - Country:US
Mailing Address - Phone:814-215-8322
Mailing Address - Fax:
Practice Address - Street 1:1356 PENNSYLVANIA AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:TYRONE
Practice Address - State:PA
Practice Address - Zip Code:16686-1620
Practice Address - Country:US
Practice Address - Phone:814-932-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor