Organization
REDKA BEHAVIOR SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MIRANDA ELIZABETH REDKA LBS (OWNER/ADMINISTRATIVE DIRECTOR)
(570) 447-2105
Entity
Organization
Contact information
Practice address
320 E 3RD ST, WILLIAMSPORT, PA 17701-5313
(570) 447-2105
Mailing address
320 E 3RD ST, WILLIAMSPORT, PA 17701-5313
(570) 447-2105
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Enumeration date
09/01/2023
Last updated
09/05/2024
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