Individual
JACQUELINE GODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
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
1-10-7630
PA
Other
Enumeration date
07/07/2012
Last updated
08/12/2021
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