Healthcare Provider Details

I. General information

NPI: 1861411878
Provider Name (Legal Business Name): SHEREE A CONTRES PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 LANCASTER BLVD
MECHANICSBURG PA
17055-3562
US

IV. Provider business mailing address

175 LANCASTER BLVD P O BOX 2028
MECHANICSBURG PA
17055-3562
US

V. Phone/Fax

Practice location:
  • Phone: 717-691-3755
  • Fax: 717-790-8505
Mailing address:
  • Phone: 717-691-3755
  • Fax: 717-790-8505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS007104L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: