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General NPI Number Information
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NPI Number | 1881194041
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Entity Type | Individual
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Provider Name | MALORIE ANNE HUBERT
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Gender | Female
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Dates
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Enumeration Date | 02/14/2018
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Last Update Date | 02/14/2018
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Provider Practice Location Address
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Address Line | 526 NEW STREET
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City | SPRING CITY
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State | PA
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Zip | 19475
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Country | US
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Telephone | 484-919-3332
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Fax |
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Provider Business Mailing Address
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Address Line | 526 NEW ST
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City | SPRING CITY
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State | PA
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Zip | 19475-1637
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Country | US
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Telephone |
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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 | BH003498
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License Number State | PA
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