Provider Demographics
NPI:1720061872
Name:NEWMAN, DENISE ELLEN (MA)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:ELLEN
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 1054
Mailing Address - Street 2:OLD STONEHOUSE ROAD
Mailing Address - City:HERNDON
Mailing Address - State:PA
Mailing Address - Zip Code:17830-9770
Mailing Address - Country:US
Mailing Address - Phone:570-758-2987
Mailing Address - Fax:570-758-5275
Practice Address - Street 1:978 STATE ROUTE 209
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17061-8002
Practice Address - Country:US
Practice Address - Phone:717-692-5294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS005748L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist