Provider Demographics
NPI:1982219788
Name:SOUTHWICK, JOSEPHINE A (BCBA)
Entity Type:Individual
Prefix:
First Name:JOSEPHINE
Middle Name:A
Last Name:SOUTHWICK
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 BETHLEHEM PIKE # B
Mailing Address - Street 2:
Mailing Address - City:ERDENHEIM
Mailing Address - State:PA
Mailing Address - Zip Code:19038-8255
Mailing Address - Country:US
Mailing Address - Phone:215-356-8561
Mailing Address - Fax:
Practice Address - Street 1:500 OFFICE CENTER DR
Practice Address - Street 2:
Practice Address - City:FT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3219
Practice Address - Country:US
Practice Address - Phone:215-540-2150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst