Individual
JESSICA MENNIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSL
Contact information
Practice address
221 MAHANTONGO ST, POTTSVILLE, PA 17901-3010
(570) 622-6417
Mailing address
221 MAHANTONGO ST, POTTSVILLE, PA 17901-3010
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
347
PA
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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