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General NPI Number Information
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NPI Number | 1083012447
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Entity Type | Organization
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Legal Business Name | SO LOVE AUTISTIC CENTER
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Dates
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Enumeration Date | 12/16/2014
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 335 BISHOP HOLLOW RD
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-3255
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Country | US
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Telephone | 610-446-3680
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Fax | 484-652-2185
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Provider Business Mailing Address
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Address Line | 335 BISHOP HOLLOW RD
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City | NEWTOWN SQUARE
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State | PA
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Zip | 19073-3255
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Country | US
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Telephone | 610-446-3680
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Fax | 484-652-2185
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Authorized Official
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Title or Position | FOUNDER/EXECUTIVE DIRECTOR
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Name | MRS. VENUS A DAVID
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Credential | M.ED., LBS
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Telephone | 610-446-3680
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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 |
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License Number State |
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