Individual
AMY ANTONIOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA, LBS
Contact information
Practice address
1 W MAIN ST, FLEETWOOD, PA 19522-1350
(814) 596-2931
Mailing address
ONE WEST MAIN ST., FLEETWOOD, PA 19522-1356
(814) 596-2931
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
BH005613
PA
Other
Enumeration date
02/01/2017
Last updated
11/08/2021
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