Individual
SHARITA REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1019 69TH AVE, PHILADELPHIA, PA 19126-2911
(215) 500-4177
Mailing address
1019 69TH AVE, PHILADELPHIA, PA 19126-2911
(215) 500-4177
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH002142
PA
Other
Enumeration date
06/04/2016
Last updated
06/04/2016
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