Individual
ERIC SIDENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
476 MARTIN ST, PHILADELPHIA, PA 19128-3422
(215) 483-2740
Mailing address
476 MARTIN ST, PHILADELPHIA, PA 19128-3422
(215) 483-2740
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH001340
PA
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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