Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003325291 |
---|---|
Provider Name | Kendra Fischer |
First Address | Media, PA 19063-5127 |
Second Address | Media, PA 19063-1751 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2017 |
Last Update Date | 17/03/2018 |