Provider Demographics
NPI:1912736034
Name:THATCHER, AMY ELIZABETH (MED, BCBA, LBS)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:THATCHER
Suffix:
Gender:F
Credentials:MED, BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 ARCH ST
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-1202
Mailing Address - Country:US
Mailing Address - Phone:484-764-2832
Mailing Address - Fax:
Practice Address - Street 1:111 RESEARCH DR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-4731
Practice Address - Country:US
Practice Address - Phone:610-758-5826
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH007167103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst