Individual
LINDA VAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10541 DRUMMOND RD, PHILADELPHIA, PA 19154-3807
(215) 888-5485
Mailing address
2427 E FIRTH ST, PHILADELPHIA, PA 19125-3108
(267) 231-0730
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH002885
PA
Other
Enumeration date
01/03/2016
Last updated
01/03/2016
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