Provider Demographics
NPI:1669864963
Name:SPORY, TIMOTHY
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:
Last Name:SPORY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 R UPPER RD
Mailing Address - Street 2:
Mailing Address - City:STOYSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15563-8188
Mailing Address - Country:US
Mailing Address - Phone:814-701-1082
Mailing Address - Fax:
Practice Address - Street 1:133 R UPPER RD
Practice Address - Street 2:
Practice Address - City:STOYSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15563-8188
Practice Address - Country:US
Practice Address - Phone:814-701-1082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist