Provider Demographics
NPI:1689755803
Name:SCHREFFLER, AMY KEEFER (PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:KEEFER
Last Name:SCHREFFLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:KEEFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:283 S BUTLER ROAD
Mailing Address - Street 2:
Mailing Address - City:MT GRETNA
Mailing Address - State:PA
Mailing Address - Zip Code:17064-0550
Mailing Address - Country:US
Mailing Address - Phone:800-932-0359
Mailing Address - Fax:
Practice Address - Street 1:283 S BUTLER ROAD
Practice Address - Street 2:
Practice Address - City:MT GRETNA
Practice Address - State:PA
Practice Address - Zip Code:17064-0550
Practice Address - Country:US
Practice Address - Phone:800-932-0359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015677103T00000X
MD04562103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
097726GHEMedicare ID - Type Unspecified