1033639315 NPI number — MS. ADRIANE JOY SHROYER M. ED. CCC-SLP

Table of content: MS. ADRIANE JOY SHROYER M. ED. CCC-SLP (NPI 1033639315)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033639315 NPI number — MS. ADRIANE JOY SHROYER M. ED. CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHROYER
Provider First Name:
ADRIANE
Provider Middle Name:
JOY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M. ED. CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033639315
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
900 WILLOW VALLEY LAKES DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLOW STREET
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17584-9663
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-464-6861
Provider Business Mailing Address Fax Number:
717-464-8444

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
900 WILLOW VALLEY LAKES DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLOW STREET
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17584-9663
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-464-6861
Provider Business Practice Location Address Fax Number:
717-464-8444
Provider Enumeration Date:
06/27/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  01462L , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 235Z00000X , with the licence number: SL013960 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)