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General NPI Number Information
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NPI Number | 1598048308
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Entity Type | Organization
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Legal Business Name | STAUFFER PSYCHOLOGICAL SERVICES
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 09/28/2011
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Provider Practice Location Address
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Address Line | 560 RISING SUN LN
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City | MILLERSBURG
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State | PA
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Zip | 17061-1243
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Country | US
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Telephone | 717-692-5200
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Fax | 717-692-5201
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Provider Business Mailing Address
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Address Line | 168 KINSINGER RD
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City | HALIFAX
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State | PA
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Zip | 17032-9449
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Country | US
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Telephone | 717-692-5200
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Fax | 717-692-5201
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CYNTHIA STAUFFER
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Credential | MS
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Telephone | 717-579-6715
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | P5006799L
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License Number State | PA
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