Provider Demographics
NPI:1366442790
Name:FEASTER, BAMBI L (BA)
Entity Type:Individual
Prefix:MS
First Name:BAMBI
Middle Name:L
Last Name:FEASTER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MS
Other - First Name:BAMBI
Other - Middle Name:L
Other - Last Name:GEIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:632 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-5230
Mailing Address - Country:US
Mailing Address - Phone:717-273-1710
Mailing Address - Fax:717-273-1416
Practice Address - Street 1:632 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5230
Practice Address - Country:US
Practice Address - Phone:717-273-1710
Practice Address - Fax:717-273-1416
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor