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Individual

JENNY DIETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
1630 MANHEIM PIKE STE 2, LANCASTER, PA 17601-3064
(717) 945-6491
Mailing address
1630 MANHEIM PIKE STE 2, LANCASTER, PA 17601-3064
(717) 945-6491

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BCBA
1-18-33192
PA
Enumeration date
09/17/2019
Last updated
09/17/2019
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