Individual
JACQUELYN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. ED., LBS
Contact information
Practice address
224 NAZARETH PIKE UNIT 22A, BETHLEHEM, PA 18020-9084
(610) 365-8373
Mailing address
142 N MAIN ST, NAZARETH, PA 18064-1416
(610) 442-7371
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
BH005242
PA
Other
Enumeration date
01/28/2021
Last updated
02/09/2021
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