Organization
EAO INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUZANNE MARIE AIL PH.D. (PRESIDENT)
(717) 627-3139
Entity
Organization
Contact information
Practice address
57 E MAIN ST, LITITZ, PA 17543-1941
(717) 627-3139
(717) 627-4455
Mailing address
57 E MAIN ST, LITITZ, PA 17543-1941
(717) 627-3139
(717) 627-4455
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS005220L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02522500
CAPITAL BLUE CROSS
PA
Enumeration date
03/12/2007
Last updated
08/22/2020
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