Individual
MRS. KIMBERLY REVELEY-COHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LBS
Contact information
Practice address
10517 RAYSTOWN RD, HUNTINGDON, PA 16652-7545
(814) 506-8143
Mailing address
10517 RAYSTOWN RD, HUNTINGDON, PA 16652-7545
(814) 506-8143
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH000948
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH000948
BEHAVIORAL SPECIALIST LICENSE
PA
Enumeration date
04/06/2016
Last updated
04/06/2016
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