Provider Demographics
NPI:1336745488
Name:ROOFNER, JOANNE MARIE
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:MARIE
Last Name:ROOFNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 KITTANNING HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:EAST BRADY
Mailing Address - State:PA
Mailing Address - Zip Code:16028-2608
Mailing Address - Country:US
Mailing Address - Phone:814-229-3162
Mailing Address - Fax:
Practice Address - Street 1:125 LOGANS FERRY RD
Practice Address - Street 2:
Practice Address - City:LOWER BURRELL
Practice Address - State:PA
Practice Address - Zip Code:15068-2048
Practice Address - Country:US
Practice Address - Phone:866-419-1693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker