Individual
JILL EVELYN HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2909 ROUTE 100 STE 110, OREFIELD, PA 18069-2951
(570) 460-0050
Mailing address
1168J S CEDAR CREST BLVD, ALLENTOWN, PA 18103-8107
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH005143
PA
Other
Enumeration date
11/17/2020
Last updated
11/17/2020
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