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Individual

MISS TREVA RICHARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
722 WINTON ST, PHILADELPHIA, PA 19148-3256
(484) 410-9315
Mailing address
722 WINTON ST, PHILADELPHIA, PA 19148-3256
(484) 410-9315

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary

Other

Enumeration date
11/15/2011
Last updated
11/15/2011
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