Provider Demographics
NPI:1750683082
Name:MAYFIELD, KELLY (BSN)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:L
Other - Last Name:FINKBINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17046-5040
Mailing Address - Country:US
Mailing Address - Phone:717-273-1710
Mailing Address - Fax:717-273-1416
Practice Address - Street 1:302 W ORANGE ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3749
Practice Address - Country:US
Practice Address - Phone:717-392-8848
Practice Address - Fax:717-397-5290
Is Sole Proprietor?:No
Enumeration Date:2010-11-18
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst