Individual
JODI MCGOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LBS, BCBA
Contact information
Practice address
2501 OREGON PIKE, LANCASTER, PA 17601-4890
(717) 735-1954
(717) 270-2472
Mailing address
121 E OAK ST, PALMYRA, PA 17078-2440
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH000999
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12694555
CAQH
—
01
—
BH000999
STATE LICENSE
PA
Enumeration date
05/19/2014
Last updated
09/27/2022
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