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Individual

NANCY ELBASTAWISY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
125 SCHNEIDER DR UNIT B, LEBANON, PA 17046-4875
(717) 270-2425
Mailing address
632 PONDSIDE LN, LEBANON, PA 17042-9479
(646) 510-6076

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH006767
PA

Other

Enumeration date
10/31/2023
Last updated
10/31/2023
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