Individual
CHRISTIAN WHITEBREAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
413 FAIRMOUNT AVE STE 1, PHILADELPHIA, PA 19123-2872
(267) 908-7772
Mailing address
4055 RIDGE AVE APT 7306, PHILADELPHIA, PA 19129-1594
(570) 956-9470
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-30608
PA
Other
Enumeration date
01/20/2020
Last updated
01/20/2020
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