Individual
MRS. JENNIFER ANN GROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
2909 ROUTE 100 STE 110, OREFIELD, PA 18069-2951
(484) 264-0916
Mailing address
5624 WOOD LN, ALLENTOWN, PA 18106-9547
(484) 553-1858
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH004741
PA
Other
Enumeration date
12/11/2019
Last updated
12/11/2019
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