Provider Demographics
NPI:1689684391
Name:SCHREIBER, MAUREEN DALEY (PH D)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:DALEY
Last Name:SCHREIBER
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 PHEASANT MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1567
Mailing Address - Country:US
Mailing Address - Phone:215-628-9792
Mailing Address - Fax:
Practice Address - Street 1:970 PHEASANT MEADOW RD
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1567
Practice Address - Country:US
Practice Address - Phone:215-628-9792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004852-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0049283000OtherBLUE CROSS/PERSONAL CHOIC
PA4554421OtherAETNA
PA039768Medicare ID - Type Unspecified