Individual
AUTUMN MICHELE CIACCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
123 WILLOW DR, LEVITTOWN, PA 19054-3118
(215) 771-4178
Mailing address
123 WILLOW DR, LEVITTOWN, PA 19054-3118
(215) 771-4178
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-1939893
PA
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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