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Individual

KIMBERLY ANN POPOVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BSL, M.ED

Contact information

Practice address
5300 KIDSPEACE DR, OREFIELD, PA 18069-2098
(484) 264-0966
Mailing address
1409 SEIDERSVILLE RD, BETHLEHEM, PA 18015-4219
(484) 264-0966

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH002162
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BH002162
BUREAU OF PROFESSIONAL AND OCCUPATIONAL AFFAIRS
PA
Enumeration date
05/29/2018
Last updated
05/29/2018
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