Provider Demographics
NPI:1932469624
Name:CIESIELSKI, EVA H (MFT)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:H
Last Name:CIESIELSKI
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 CAROL RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-3865
Mailing Address - Country:US
Mailing Address - Phone:717-755-0921
Mailing Address - Fax:717-751-0783
Practice Address - Street 1:2870 CAROL RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-3865
Practice Address - Country:US
Practice Address - Phone:717-755-0921
Practice Address - Fax:717-751-0783
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF000373106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist