Individual
MRS. JENNIFER LYNN FAGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10541 DRUMMOND RD, PHILADELPHIA, PA 19154-3807
(215) 207-4647
Mailing address
8637 DEER LN, PHILADELPHIA, PA 19136-2015
(215) 680-7886
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH000216
PA
Other
Enumeration date
11/09/2006
Last updated
01/07/2016
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