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640 Freedom Business Ctr Dr Ste 220 King Of Prussia PA 19406-1376 | |
| (484) 965-9966 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 640 Freedom Business Ctr Dr Ste 220, King Of Prussia, Pennsylvania |
| Authorized Official Name and Position | Jeanine Weichelt (CHIEF OPERATIONS OFFICER) |
| Authorized Official Contact | 4843934107 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
640 Freedom Business Ctr Dr Ste 220 King Of Prussia PA 19406-1376 Ph: (484) 393-4107 | 640 Freedom Business Ctr Dr Ste 220 King Of Prussia PA 19406-1376 Ph: (484) 965-9966 |
| NPI Number | 1720701501 |
|---|---|
| Provider Enumeration Date | 09/26/2022 |
| Last Update Date | 04/19/2023 |
| Certification Date | 04/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720701501 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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