Provider Demographics
NPI:1104212067
Name:MCAFEE, SALLY ANN (MED)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:ANN
Last Name:MCAFEE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 OLD FORGE XING
Mailing Address - Street 2:
Mailing Address - City:DEVON
Mailing Address - State:PA
Mailing Address - Zip Code:19333-1119
Mailing Address - Country:US
Mailing Address - Phone:610-688-1471
Mailing Address - Fax:
Practice Address - Street 1:78 OLD FORGE XING
Practice Address - Street 2:
Practice Address - City:DEVON
Practice Address - State:PA
Practice Address - Zip Code:19333-1119
Practice Address - Country:US
Practice Address - Phone:610-688-1471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007923101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional