Individual
BRIDGET FITZSIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
193 MARKET ST, KINGSTON, PA 18704-5409
(570) 846-0455
Mailing address
193 MARKET ST, KINGSTON, PA 18704-5409
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-27299
PA
Other
Enumeration date
10/29/2018
Last updated
10/29/2018
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