Provider Demographics
NPI:1881321545
Name:SHAFFER, ABIGAIL (NTP)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:SHAFFER
Suffix:
Gender:F
Credentials:NTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:689 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BROCKWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15824-1403
Mailing Address - Country:US
Mailing Address - Phone:814-661-8091
Mailing Address - Fax:
Practice Address - Street 1:689 MAPLE ST
Practice Address - Street 2:
Practice Address - City:BROCKWAY
Practice Address - State:PA
Practice Address - Zip Code:15824-1403
Practice Address - Country:US
Practice Address - Phone:814-661-8091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No171400000XOther Service ProvidersHealth & Wellness Coach