Individual
KYLE RICHARD LIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LBS
Contact information
Practice address
1630 MANHEIM PIKE STE 2, LANCASTER, PA 17601-3064
(717) 945-6491
Mailing address
143 15TH ST APT 8, NEW CUMBERLAND, PA 17070-1100
(717) 715-5007
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH006525
PA
Other
Enumeration date
05/15/2024
Last updated
05/15/2024
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