Individual
IRESHA PICOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1219 S 52ND ST APT 2, PHILADELPHIA, PA 19143-4362
(215) 820-8199
Mailing address
1219 S 52ND ST APT 2, PHILADELPHIA, PA 19143-4362
(215) 820-8199
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH001283
PA
Other
Enumeration date
02/16/2016
Last updated
02/16/2016
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