Individual
GBENADE AMOSU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7029 RUTLAND ST, PHILADELPHIA, PA 19149-1717
(215) 941-9885
(215) 821-2029
Mailing address
7029 RUTLAND ST, PHILADELPHIA, PA 19149-1717
(215) 941-9885
(215) 821-2029
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH002827
PA
Other
Enumeration date
09/11/2015
Last updated
09/11/2015
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