Individual
JILL REVERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1477 E 83RD AVE, MERRILLVILLE, IN 46410-6307
(219) 472-0628
(219) 750-9287
Mailing address
1477 E 83RD AVE, MERRILLVILLE, IN 46410-6307
(219) 472-0628
(219) 750-9287
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/21/2010
Last updated
06/25/2021
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