Provider Demographics
NPI:1952571556
Name:BRUNETTI, CHRISTINE (MA, NCC, LPC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BRUNETTI
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:978 CONSTITUTION AVE
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:PA
Mailing Address - Zip Code:18434-1309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:978 CONSTITUTION AVE
Practice Address - Street 2:
Practice Address - City:JESSUP
Practice Address - State:PA
Practice Address - Zip Code:18434-1309
Practice Address - Country:US
Practice Address - Phone:570-383-9903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003505101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional