Provider Demographics
NPI:1457783912
Name:YU, KRISTEN DILZELL (MS, CGC)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:DILZELL
Last Name:YU
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:DILZELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:15 WESNER LN # MC24-80
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-8023
Mailing Address - Country:US
Mailing Address - Phone:570-214-2637
Mailing Address - Fax:570-214-7342
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-8023
Practice Address - Country:US
Practice Address - Phone:570-214-0562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL246.000289170300000X
170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS