=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760144612
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLISON STERNER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/07/2021
-----------------------------------------------------
Last Update Date | 10/07/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4041 SHERRY HILL RD
-----------------------------------------------------
City | HELLERTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18055-3346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-248-2169
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4041 SHERRY HILL RD
-----------------------------------------------------
City | HELLERTOWN
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18055-3346
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number | BH005576
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------