Healthcare Provider Details

I. General information

NPI: 1487581427
Provider Name (Legal Business Name): MRS. MARIE HASSIEPEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 N PRINCE ST
LANCASTER PA
17603-3010
US

IV. Provider business mailing address

410 N PRINCE ST
LANCASTER PA
17603-3010
US

V. Phone/Fax

Practice location:
  • Phone: 717-560-7917
  • Fax: 717-560-6452
Mailing address:
  • Phone: 717-560-7917
  • Fax: 717-560-6452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH008412
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: