Provider Demographics
NPI:1063614105
Name:KRAYBILL, DONALD E (PHD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:E
Last Name:KRAYBILL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 N. SUMNEYTOWN PIKE
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-2530
Mailing Address - Country:US
Mailing Address - Phone:215-661-0471
Mailing Address - Fax:215-661-0468
Practice Address - Street 1:311 N SUMNEYTOWN PIKE
Practice Address - Street 2:SUITE 2A
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-2533
Practice Address - Country:US
Practice Address - Phone:215-661-0471
Practice Address - Fax:215-661-0468
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-004815-L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAKR 063218Medicare ID - Type Unspecified