Provider Demographics
NPI:1336156066
Name:SWIETLIK-KIEFFER, GLORIA ANN (LICENSED PSYCHOLOGIS)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:ANN
Last Name:SWIETLIK-KIEFFER
Suffix:
Gender:F
Credentials:LICENSED PSYCHOLOGIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 HARRISON DRIVE
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412
Mailing Address - Country:US
Mailing Address - Phone:814-734-1001
Mailing Address - Fax:
Practice Address - Street 1:1910 SASSAFRAS ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502
Practice Address - Country:US
Practice Address - Phone:814-452-5573
Practice Address - Fax:814-452-7610
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007385L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist