Provider Demographics
NPI:1710871819
Name:GIFFORD, SHAINA L
Entity type:Individual
Prefix:
First Name:SHAINA
Middle Name:L
Last Name:GIFFORD
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 1:216 1/2 W CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-2901
Mailing Address - Country:US
Mailing Address - Phone:717-521-3681
Mailing Address - Fax:
Practice Address - Street 1:55 WETZEL DR STE 3
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1131
Practice Address - Country:US
Practice Address - Phone:717-220-3336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC001322101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional