Provider Demographics
NPI:1700104890
Name:HINES, KELLY ANNE
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ANNE
Last Name:HINES
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 1:102 DORSCH LN
Mailing Address - Street 2:
Mailing Address - City:NEW DERRY
Mailing Address - State:PA
Mailing Address - Zip Code:15671-1041
Mailing Address - Country:US
Mailing Address - Phone:724-388-2775
Mailing Address - Fax:
Practice Address - Street 1:ONE CORPORATE CIRCLE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9700
Practice Address - Country:US
Practice Address - Phone:724-850-7300
Practice Address - Fax:724-850-7778
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health