Provider Demographics
NPI:1992301972
Name:SHEAFFER, BRENNA (MT-BC)
Entity type:Individual
Prefix:
First Name:BRENNA
Middle Name:
Last Name:SHEAFFER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 E WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-2051
Mailing Address - Country:US
Mailing Address - Phone:717-524-6410
Mailing Address - Fax:
Practice Address - Street 1:25 BEECHWOOD LN
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-1702
Practice Address - Country:US
Practice Address - Phone:717-524-6410
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA17-THERAPISTOtherMUSIC THERAPY