Individual
KRISTA R BUCHANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1002 CUB CT, EFFORT, PA 18330-8035
(570) 656-4047
Mailing address
PO BOX 961, EFFORT, PA 18330-0961
(570) 656-4047
Taxonomy
Speciality
Code
Description
License number
State
235500000X
Speech/Language/Hearing Specialist/Technologist
3975912
PA
235Z00000X
Speech-Language Pathologist
3975912
PA
252Y00000X
Early Intervention Provider Agency
Primary
3975912
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0421880137-8
PROFESIONAL INSURANCE POLICY NUMBER
PA
Enumeration date
03/27/2015
Last updated
03/27/2015
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