Organization
BEYOND AUTISM SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE GODWIN (CLINICAL DIRECTOR)
(484) 431-4677
Entity
Organization
Contact information
Practice address
77 W BALTIMORE PIKE STE 100B, MEDIA, PA 19063-5639
(610) 572-5520
(610) 572-5521
Mailing address
77 W BALTIMORE PIKE STE 100B, MEDIA, PA 19063-5639
(610) 572-5520
(610) 572-5521
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/12/2021
Last updated
08/12/2021
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