Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | PA | |
N | 106S00000X | Behavior Technician | PA |
NPI | 1003583121 |
---|---|
Provider Name | Jennifer Bernabe |
First Address | Easton, PA 18042-3173 |
Second Address | Easton, PA 18042-3173 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2021 |
Last Update Date | 26/08/2021 |