Individual
JENNA SUDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1607 3RD ST, BEAVER, PA 15009-2420
(724) 728-8400
Mailing address
1607 3RD ST, BEAVER, PA 15009-2420
(724) 728-8400
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BH003183
PA
Other
Enumeration date
12/23/2016
Last updated
12/23/2016
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