Provider Demographics
NPI:1003016114
Name:HARBERGER, SANDRA LYNN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LYNN
Last Name:HARBERGER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:LYNN
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1523 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-1908
Mailing Address - Country:US
Mailing Address - Phone:717-364-2574
Mailing Address - Fax:
Practice Address - Street 1:1800 E MARKET ST STE B
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402
Practice Address - Country:US
Practice Address - Phone:717-364-7778
Practice Address - Fax:717-382-0196
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007966235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASL007966OtherPA SPEECH LANGUAGE PATHOL