Provider Demographics
NPI:1639390560
Name:SILLIKER, MARY JOSITA (REV)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:JOSITA
Last Name:SILLIKER
Suffix:
Gender:F
Credentials:REV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 FIRESIDE DR
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1422
Mailing Address - Country:US
Mailing Address - Phone:717-737-9553
Mailing Address - Fax:
Practice Address - Street 1:4701 DEVONSHIRE RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-1746
Practice Address - Country:US
Practice Address - Phone:717-737-9553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral