Provider Demographics
NPI:1659041812
Name:ETNOYER, KIRSTEN (LPC)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:ETNOYER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-1440
Mailing Address - Country:US
Mailing Address - Phone:814-456-2091
Mailing Address - Fax:814-456-1677
Practice Address - Street 1:329 W 10TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-1440
Practice Address - Country:US
Practice Address - Phone:814-456-2091
Practice Address - Fax:814-456-1677
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005449101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional