Organization
INDEPENDENT DEVELOPMENTAL ASSESSMEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA KAYE SHEPLER (SOLE PROPRIETOR)
(814) 427-4206
Entity
Organization
Contact information
Practice address
5518 ROUTE 119, PUNXSUTAWNEY, PA 15767-4050
(814) 427-4206
Mailing address
5518 ROUTE 119, PUNXSUTAWNEY, PA 15767-4050
(814) 427-4206
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL004971L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101652428
MEDICAL ASSISTANCE NUMBER
PA
Enumeration date
02/26/2007
Last updated
06/18/2008
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