Provider Demographics
NPI:1174921654
Name:THE SHAFER CENTER FOR EARLY INTERVENTION
Entity type:Organization
Organization Name:THE SHAFER CENTER FOR EARLY INTERVENTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ACCARDO
Authorized Official - Last Name:HOREL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:410-517-1113
Mailing Address - Street 1:11500 CRONRIDGE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-2261
Mailing Address - Country:US
Mailing Address - Phone:410-517-1113
Mailing Address - Fax:
Practice Address - Street 1:11500 CRONRIDGE DR STE 130
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-2261
Practice Address - Country:US
Practice Address - Phone:410-517-1113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency