Provider Demographics
NPI:1134257389
Name:SNYDER,UNION,MIFFLIN CHILD DEVELOPMENT,INC
Entity type:Organization
Organization Name:SNYDER,UNION,MIFFLIN CHILD DEVELOPMENT,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:G
Authorized Official - Last Name:KOPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-966-2845
Mailing Address - Street 1:14 S 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MIFFLINBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17844-9792
Mailing Address - Country:US
Mailing Address - Phone:570-966-2845
Mailing Address - Fax:570-966-9693
Practice Address - Street 1:14 S 11TH ST
Practice Address - Street 2:
Practice Address - City:MIFFLINBURG
Practice Address - State:PA
Practice Address - Zip Code:17844-9792
Practice Address - Country:US
Practice Address - Phone:570-966-2845
Practice Address - Fax:570-966-9693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty