Healthcare Provider Details

I. General information

NPI: 1275498834
Provider Name (Legal Business Name): JUDITH SMITHEY BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3502 SCOTTS LN STE 404
PHILADELPHIA PA
19129-1697
US

IV. Provider business mailing address

218 LINDEN AVE
RUTLEDGE PA
19070-1819
US

V. Phone/Fax

Practice location:
  • Phone: 610-952-2755
  • Fax:
Mailing address:
  • Phone: 484-686-3788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH004402
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: