Healthcare Provider Details
I. General information
NPI: 1487601563
Provider Name (Legal Business Name): SAUNDRA LEE SCHOICKET PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/27/2006
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
561 W CHOCOLATE AVE
HERSHEY PA
17033-1676
US
IV. Provider business mailing address
1082 DERRY WOODS DR
HUMMELSTOWN PA
17036-9715
US
V. Phone/Fax
- Phone: 717-534-1808
- Fax: 717-534-6599
- Phone: 717-534-1808
- Fax: 717-534-6599
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 001973 |
| License Number State | GA |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 1033521710001 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
| # 2 | |
| Identifier | 00702028A |
| Identifier Type | MEDICAID |
| Identifier State | GA |
| Identifier Issuer | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: