Individual
STACEY EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
232 JACKSON AVE, LANSDOWNE, PA 19050-1411
(609) 828-3348
Mailing address
232 JACKSON AVE, LANSDOWNE, PA 19050-1411
(609) 828-3348
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-11-8617
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-11-8617
BEHAVIOR ANALYST CERTIFICATION BOARD
—
01
—
BH001514
PENNSYLVANIA DEPT OF STATE BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS
PA
Enumeration date
11/03/2015
Last updated
11/03/2015
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