Individual
MISS JEANMARIE DEISSLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3328 ALDINE ST, PHILADELPHIA, PA 19136-3802
(267) 304-9238
Mailing address
3328 ALDINE ST, PHILADELPHIA, PA 19136-3802
(267) 304-9238
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
27830773
PA
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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