Provider Demographics
NPI:1174707194
Name:STACHOWSKI, DEBBIE ANN
Entity type:Individual
Prefix:MRS
First Name:DEBBIE
Middle Name:ANN
Last Name:STACHOWSKI
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 1:101 WEST MAIN ST
Mailing Address - Street 2:PO BOX 37
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827
Mailing Address - Country:US
Mailing Address - Phone:814-466-7470
Mailing Address - Fax:814-466-7407
Practice Address - Street 1:101 WEST MAIN ST
Practice Address - Street 2:
Practice Address - City:BOALSBURG
Practice Address - State:PA
Practice Address - Zip Code:16827
Practice Address - Country:US
Practice Address - Phone:814-466-7470
Practice Address - Fax:814-466-7407
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist