Individual
MRS. DAWN JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BEHAVIOR SPECIALIST
Contact information
Practice address
1195 ROOSEVELT AVE, YORK, PA 17404-2350
(717) 843-0800
Mailing address
6658 FAIR SCHOOL RD, GLEN ROCK, PA 17327-7848
(717) 235-2827
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
103K00000X
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH000383
BUREAU OF PROFESSINAL AND OCCUPATIONAL AFFAIRS
PA
Enumeration date
05/27/2014
Last updated
05/27/2014
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