Healthcare Provider Details

I. General information

NPI: 1346615606
Provider Name (Legal Business Name): TERESSA PRICE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2015
Last Update Date: 12/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 COMMERCE DR
HARRISBURG PA
17110-9365
US

IV. Provider business mailing address

2700 COMMERCE DR
HARRISBURG PA
17110-9365
US

V. Phone/Fax

Practice location:
  • Phone: 717-901-9906
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH002849
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: