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General NPI Number Information
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NPI Number | 1992108997
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Entity Type | Organization
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Legal Business Name | CENTRAL PENN EDUCATION ASSOCIATES LLC
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Dates
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Enumeration Date | 10/03/2014
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Last Update Date | 10/03/2014
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Provider Practice Location Address
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Address Line | 3920 MARKET ST
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City | CAMP HILL
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State | PA
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Zip | 17011-4202
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Country | US
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Telephone | 717-805-6248
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Fax |
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Provider Business Mailing Address
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Address Line | 2450 DEWEY LN
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City | ENOLA
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State | PA
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Zip | 17025-1357
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Country | US
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Telephone | 717-805-6248
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANTHONY JOSEPH BAVARIA
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Credential | MS, NCSP
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Telephone | 717-805-6248
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 2826402718304186375
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License Number State | PA
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