Provider Demographics
NPI:1134299597
Name:FEATHERMAN, ARDIS A (MS)
Entity Type:Individual
Prefix:
First Name:ARDIS
Middle Name:A
Last Name:FEATHERMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 CAROL RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-3865
Mailing Address - Country:US
Mailing Address - Phone:717-755-0921
Mailing Address - Fax:717-751-0783
Practice Address - Street 1:2870 CAROL RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-3865
Practice Address - Country:US
Practice Address - Phone:717-755-0921
Practice Address - Fax:717-751-0783
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005123L103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA557123OtherBLUE SHIELD
PA403859OtherVALUE OPTIONS
PA50050652OtherBLUE CROSS
PA0375302000OtherMAGELLAN