Individual
MARY FANELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
340 S LIBERTY ST, ORWIGSBURG, PA 17961-2127
(570) 366-1154
(570) 366-7711
Mailing address
401 S MARGARETTA ST, SCHUYLKILL HAVEN, PA 17972-1709
(570) 449-1869
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH001769
PA
Other
Enumeration date
06/24/2014
Last updated
06/25/2014
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