Provider Demographics
NPI:1922179019
Name:RISHELL, SANDRA W (CMT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:W
Last Name:RISHELL
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 BELLEFONTE AVE
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-2576
Mailing Address - Country:US
Mailing Address - Phone:570-748-4995
Mailing Address - Fax:
Practice Address - Street 1:57 BELLEFONTE AVE
Practice Address - Street 2:
Practice Address - City:LOCK HAVEN
Practice Address - State:PA
Practice Address - Zip Code:17745-2576
Practice Address - Country:US
Practice Address - Phone:570-748-4995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist