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Individual

JENNIFER LEIGH KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, BCBA

Contact information

Practice address
437 E FLORA ST, PHILADELPHIA, PA 19125-3315
(215) 432-8991
Mailing address
PO BOX 15224, PHILADELPHIA, PA 19125-0224
(215) 432-8991

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-02-1026
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-02-1026
BCBA NUMBER
PA
Enumeration date
06/06/2011
Last updated
06/06/2011
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