Individual
SADIQ LOCUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 N JACKSON ST STE 203, MEDIA, PA 19063-2574
(484) 444-2285
Mailing address
PO BOX 20503, LEHIGH VALLEY, PA 18002-0503
(484) 335-6100
(484) 335-6104
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1-19-35788
PA
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-19-35788
BACB
PA
01
—
RBT-15-03063
BACB REGISTRATION NUMBER
—
Enumeration date
03/03/2019
Last updated
07/26/2019
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