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Individual

MARY CHRISTINE REMICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., BCBA

Contact information

Practice address
421 S STATE ST, CLARKS SUMMIT, PA 18411-1684
(570) 319-6965
(570) 319-6966
Mailing address
RR 4 BOX 35A, DALTON, PA 18414-9610
(570) 563-2199
(570) 563-2199

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
#1-07-3652
PA
103TB0200X
Cognitive & Behavioral Psychologist
Primary
PS006978L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
#1-07-3652
BEHAVIOR ANALYTIC CERTIFICATION BOARD
PA
01
PS006978L
PSYCHOLOGIST LICENSE
PA
Enumeration date
08/08/2006
Last updated
05/17/2013
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