Provider Demographics
NPI:1265777411
Name:SCHAUFELE, BRENDA (LAC)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:
Last Name:SCHAUFELE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ALEXANDER RD
Mailing Address - Street 2:
Mailing Address - City:KINTNERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18930-9800
Mailing Address - Country:US
Mailing Address - Phone:484-707-0468
Mailing Address - Fax:
Practice Address - Street 1:8789 EASTON ROAD
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:PA
Practice Address - Zip Code:18953
Practice Address - Country:US
Practice Address - Phone:484-707-0468
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAKO000654171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist