Individual
IHEARIOCHI AGWAMBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LBS
Contact information
Practice address
1814 MOWER ST, PHILADELPHIA, PA 19152-1117
(267) 242-6287
Mailing address
1814 MOWER ST, PHILADELPHIA, PA 19152-1117
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH005401
PA
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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