Individual
VANESSA MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
351 TENNY ST, BLOOMSBURG, PA 17815-3264
(888) 726-4774
Mailing address
9 BANKS AVE, MCADOO, PA 18237-2508
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/18/2021
Last updated
11/18/2021
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