Individual
KRISTINE NOCITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 WAKEFIELD RD, SHAVERTOWN, PA 18708-9760
(570) 760-4377
Mailing address
120 WAKEFIELD RD, SHAVERTOWN, PA 18708-9760
(570) 570-7604
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL005738L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017610450003
MEDICAL ASSISTANCE
PA
Enumeration date
02/22/2007
Last updated
09/23/2022
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