Provider Demographics
NPI:1609849116
Name:CHAMBERLIN, SANDRA MOORE (MS)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:MOORE
Last Name:CHAMBERLIN
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 1:2209 PIKES PEAK RD
Mailing Address - Street 2:
Mailing Address - City:ALLENWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:17810-9523
Mailing Address - Country:US
Mailing Address - Phone:570-547-1699
Mailing Address - Fax:
Practice Address - Street 1:699 RURAL AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-3246
Practice Address - Country:US
Practice Address - Phone:570-323-7000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000678L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist