Provider Demographics
NPI:1083222848
Name:SCHAMBER, WALTER R (PHD)
Entity Type:Individual
Prefix:
First Name:WALTER
Middle Name:R
Last Name:SCHAMBER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 BRANDY RUN
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415-3308
Mailing Address - Country:US
Mailing Address - Phone:814-790-8202
Mailing Address - Fax:888-221-4661
Practice Address - Street 1:7359 W RIDGE RD STE 1
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:PA
Practice Address - Zip Code:16415-1169
Practice Address - Country:US
Practice Address - Phone:814-790-8202
Practice Address - Fax:888-221-4661
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-17
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019044103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist