Provider Demographics
NPI:1326135146
Name:SHEMONSKY, MARY SANDRA
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:SANDRA
Last Name:SHEMONSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 VALLEY FORGE ROAD PO BOX 911
Mailing Address - Street 2:UNIT #38
Mailing Address - City:VALLEY FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:19482
Mailing Address - Country:US
Mailing Address - Phone:610-935-7077
Mailing Address - Fax:610-917-9888
Practice Address - Street 1:1220 VALLEY FORGE ROAD
Practice Address - Street 2:UNIT #38
Practice Address - City:VALLEY FORGE
Practice Address - State:PA
Practice Address - Zip Code:19482
Practice Address - Country:US
Practice Address - Phone:610-935-7077
Practice Address - Fax:610-917-9888
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS003338-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist