Individual
MS. JACQUELINE ELISE PENNINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
46 MYSTERY ROSE LN, WEST GROVE, PA 19390-8812
(610) 316-7307
(610) 436-1208
Mailing address
149 COLUMBIA AVE, PHOENIXVILLE, PA 19460-4052
(484) 639-7778
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-19-82909
BEHAVIOR ANALYST CERTIFICATION BOARD (BACB)
—
Enumeration date
06/22/2021
Last updated
06/22/2021
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