Individual
MR. KEVIN M LOEB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, BCBA
Contact information
Practice address
238 APPLE BLOSSOM LN, SIMPSONVILLE, SC 29681-5937
(847) 797-4896
Mailing address
33 SCARLETT ST, GREENVILLE, SC 29607
(847) 797-4896
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BA1012
—
SC
Enumeration date
11/01/2011
Last updated
07/21/2022
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