Provider Demographics
NPI:1780442996
Name:STRICKER, STEFANIE M
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:M
Last Name:STRICKER
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 1:1114 BAYBERRY RD
Mailing Address - Street 2:
Mailing Address - City:PEN ARGYL
Mailing Address - State:PA
Mailing Address - Zip Code:18072-1806
Mailing Address - Country:US
Mailing Address - Phone:570-242-1858
Mailing Address - Fax:
Practice Address - Street 1:1114 BAYBERRY RD
Practice Address - Street 2:
Practice Address - City:PEN ARGYL
Practice Address - State:PA
Practice Address - Zip Code:18072-1806
Practice Address - Country:US
Practice Address - Phone:570-242-1858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency