Individual
MS. ELAINE B, AXELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
825 CHAUNCEY RD, PENN VALLEY, PA 19072-1303
(610) 664-2560
Mailing address
825 CHAUNCEY RD, PENN VALLEY, PA 19072-1303
(610) 664-2560
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
PS00608L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84148
BLUE CROSS
PA
Enumeration date
09/11/2009
Last updated
09/11/2009
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