Provider Demographics
NPI:1366746646
Name:ONEILL, KRISTEN EDITH (MAC, LAC, LMT)
Entity type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:EDITH
Last Name:ONEILL
Suffix:
Gender:F
Credentials:MAC, LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2418 OBSERVATORY PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1814
Mailing Address - Country:US
Mailing Address - Phone:202-215-9633
Mailing Address - Fax:
Practice Address - Street 1:1610 CRYSTAL SQUARE ARC
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-3301
Practice Address - Country:US
Practice Address - Phone:703-412-1148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-31
Last Update Date:2010-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000600171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist