Individual
REVATI MCNAMARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BEHAVIOR ANALYST
Contact information
Practice address
700 W CUNNINGHAM PL APT 1109, BOISE, ID 83702-4344
(208) 514-7198
Mailing address
2304 N 20TH ST, BOISE, ID 83702-0835
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
08/05/2019
Last updated
10/17/2023
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