Individual
AUTUMN PAGE MUMICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
351 TENNY ST, BLOOMSBURG, PA 17815-3264
(888) 726-4774
Mailing address
305 SOPHIA COXE DR, FREELAND, PA 18224-3068
(570) 710-2152
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2301569311
—
PA
Enumeration date
07/09/2022
Last updated
07/11/2022
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