Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | BH000653 | PA |
NPI | 1003431677 |
---|---|
Provider Name | Janelle Mchale |
First Address | Carbondale, PA 18407-3040 |
Second Address | Carbondale, PA 18407-3040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2020 |
Last Update Date | 10/06/2020 |