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Organization
PENNSYLVANIA AUTISM ACTION CENTER LLC
Active
Organization
PENNSYLVANIA AUTISM ACTION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE MEAENY DEMARSH MED (PRINCIPAL OWNER)
(570) 992-6720
Entity
Organization
Contact information
Practice address
2071 ROUTE 209, BRODHEADSVILLE, PA 18322-7754
(570) 992-6720
(570) 992-6736
Mailing address
2071 ROUTE 209, BRODHEADSVILLE, PA 18322-7754
(570) 992-6720
(570) 992-6736
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-03-1139
PA
225XP0200X
Pediatric Occupational Therapist
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Other
Enumeration date
06/04/2013
Last updated
03/09/2017
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