Provider Demographics
NPI:1821434465
Name:SEDLACK, ANN REBECCA (M ED)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:REBECCA
Last Name:SEDLACK
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-2718
Mailing Address - Country:US
Mailing Address - Phone:610-762-9565
Mailing Address - Fax:610-682-0820
Practice Address - Street 1:216 N 4TH ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-2718
Practice Address - Country:US
Practice Address - Phone:610-762-9565
Practice Address - Fax:610-682-0820
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor