Provider Demographics
NPI:1235703646
Name:PAGE, KRISTIN EGAN (MSED, NCC)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:EGAN
Last Name:PAGE
Suffix:
Gender:F
Credentials:MSED, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 LOWRYS LN
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-1021
Mailing Address - Country:US
Mailing Address - Phone:610-659-2659
Mailing Address - Fax:
Practice Address - Street 1:240 LOWRYS LN
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1021
Practice Address - Country:US
Practice Address - Phone:610-659-2659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health