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Individual

ATHENA LAVELLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LLBS

Contact information

Practice address
2501 OREGON PIKE, LANCASTER, PA 17601-4890
(717) 735-1954
(717) 270-2472
Mailing address
785 5TH AVE STE 3, CHAMBERSBURG, PA 17201-4232
(717) 263-9555
(717) 709-6529

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH001227
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BH001227
STATE LICENSE
PA
Enumeration date
07/01/2014
Last updated
12/01/2022
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