Individual
MS. VIVIAN DANTZLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LBS
Contact information
Practice address
1116 S 20TH ST, PHILADELPHIA, PA 19146-2837
(215) 397-5450
(267) 687-1978
Mailing address
1116 S 20TH ST, PHILADELPHIA, PA 19146-2837
(215) 397-5450
(267) 687-1978
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BSL002569
PA
Other
Enumeration date
10/28/2015
Last updated
10/28/2015
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