Individual
MS. STACEY L MIKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, BCBA
Contact information
Practice address
9 BANKS AVE, MCADOO, PA 18237-2508
(570) 802-3099
Mailing address
107 MAPLE TER, NESQUEHONING, PA 18240-2125
(570) 952-4066
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
12044424
PA
Other
Enumeration date
09/24/2020
Last updated
09/24/2020
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