Healthcare Provider Details

I. General information

NPI: 1184003857
Provider Name (Legal Business Name): PEARL SENSENIG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2015
Last Update Date: 05/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 BUTLER RD BOX 550
MOUNT GRETNA PA
17064-6085
US

IV. Provider business mailing address

931 HIGH ST
AKRON PA
17501-1419
US

V. Phone/Fax

Practice location:
  • Phone: 717-270-2451
  • Fax:
Mailing address:
  • Phone: 717-859-2099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW129927
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: