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General NPI Number Information
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NPI Number | 1043104417
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Entity Type | Individual
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Provider Name | TERESA V GUERRA LBS
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Gender | Female
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Dates
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Enumeration Date | 06/09/2025
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 4601 MARKET ST
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City | PHILADELPHIA
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State | PA
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Zip | 19139-4636
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Country | US
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Telephone | 215-848-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 CONSHOHOCKEN AVE APT 3405
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City | PHILADELPHIA
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State | PA
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Zip | 19131-5425
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Country | US
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Telephone | 856-239-5001
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH007451
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License Number State | PA
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