Individual
NICOLE MCGINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1416 PINE CREST DR, SOUTH WILLIAMSPORT, PA 17702-7024
(570) 447-7435
Mailing address
1416 PINE CREST DR, SOUTH WILLIAMSPORT, PA 17702-7024
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH000787
PA
Other
Enumeration date
02/11/2019
Last updated
02/11/2019
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