| Doctor Name: | KRISTA RENEE ETCHISON |
| NPI Number: | 1093946857 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA NCC LPC |
| License Number: | PC005227 |
| Business Practice Address: | 1633 Philipsburg Bigler Hwy Philipsburg, PA - 168668112 |
| Business Phone Number: | 8143425678 |
| Business Fax Number: | |
| Mailing Address: | 119 N 4th St, PHILIPSBURG |
| State: | PA |
| Postal Code: | 168661437 |
| Phone Number: | 8145926239 |
| Fax Number: | |
| NPI Enumeration Date: | 07/28/2009 |
| NPI Last Update Date: | 07/16/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | PC005227 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |