MEDICARE: DANA SPICKLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC015429	PA

General Provider Information

NPI Number	:	1841987070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANA SPICKLER

Provider Business Mailing Address
First Line	:	140 S ANDERSON ST
Second Line	:
City	:	BEDFORD
State	:	PA
Zip	:	15522-1403
Country	:	US
Telephone Number	:	814-623-5077
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 S ANDERSON ST
Second Line	:
City	:	BEDFORD
State	:	PA
Zip	:	15522-1403
Country	:	US
Telephone Number	:	814-623-5077
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2023
Last Update Date	:	04/18/2023

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Directions to “ DANA SPICKLER ” Practice Location

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