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Individual

MS. JACQUELINE NICOLE RICHARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
2140 SAINT VINCENT ST, PHILADELPHIA, PA 19149-1333
(610) 608-7737
(215) 333-3162
Mailing address
2140 SAINT VINCENT ST, PHILADELPHIA, PA 19149-1333
(610) 608-7737
(215) 333-3162

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
103K00000X
HEALTH CARE PROVIDER TAXONOMY CODE SET
PA
Enumeration date
05/06/2009
Last updated
05/06/2009
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