Most Relevant Information
Provider Data
| NPI Number: | 1003373614 |
| Provider Name: | PATRICK CORCORAN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/01/2019 |
| Last Updated: | 03/01/2019 |
Provider Practice Location
600 N JACKSON ST STE 203
MEDIA
PA
190632574
Practice Location Phone/Fax
| Phone: | 4844442285 |
| Fax: |
Provider Mailing Location
600 N JACKSON ST STE 203
MEDIA
PA
190632574
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |