Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1083200653 |
---|---|
Provider Name | Ms. Heidi Kristin Bucks |
First Address | Bethlehem, PA 18018-6240 |
Second Address | Bethlehem, PA 18020-9084 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2020 |
Last Update Date | 17/12/2020 |