Healthcare Provider Details

I. General information

NPI: 1841320710
Provider Name (Legal Business Name): JUDITH L REPP LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JUDY L. REPP LPC

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3206 E MARKET ST
YORK PA
17402-2506
US

IV. Provider business mailing address

13233 MONT RD
FELTON PA
17322-8461
US

V. Phone/Fax

Practice location:
  • Phone: 717-751-6851
  • Fax: 717-751-6852
Mailing address:
  • Phone: 717-227-0063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License NumberPC002521
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: