Provider Demographics
NPI:1215345871
Name:SHOFF, DONNA D (BSC)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:D
Last Name:SHOFF
Suffix:
Gender:F
Credentials:BSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:381 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRING GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17362-1119
Mailing Address - Country:US
Mailing Address - Phone:717-698-9655
Mailing Address - Fax:
Practice Address - Street 1:625 W ELM AVE
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-5125
Practice Address - Country:US
Practice Address - Phone:717-632-4900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-28
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001167103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst