Provider Demographics
NPI:1528399607
Name:BIBELHEIMER, JEROME N (MSED, BCBA)
Entity Type:Individual
Prefix:
First Name:JEROME
Middle Name:N
Last Name:BIBELHEIMER
Suffix:
Gender:M
Credentials:MSED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:292 PAOLI PIKE
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-2960
Mailing Address - Country:US
Mailing Address - Phone:215-527-7228
Mailing Address - Fax:484-320-8307
Practice Address - Street 1:292 PAOLI PIKE
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-2960
Practice Address - Country:US
Practice Address - Phone:215-527-7228
Practice Address - Fax:484-320-8307
Is Sole Proprietor?:No
Enumeration Date:2010-01-29
Last Update Date:2010-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst