Doctor Name: | MS. ILDI A SHAFFER |
NPI Number: | 1073637294 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | PC003494 |
Business Practice Address: | 24 N Gait Dr Slippery Rock, PA - 160574016 |
Business Phone Number: | 7242342345 |
Business Fax Number: | 7242342345 |
Mailing Address: | 24 N Gait Dr, SLIPPERY ROCK |
State: | PA |
Postal Code: | 160574016 |
Phone Number: | 7242342345 |
Fax Number: | 7242342345 |
NPI Enumeration Date: | 03/16/2007 |
NPI Last Update Date: | 12/03/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | PC003494 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |