Provider Demographics
NPI:1043835739
Name:BIEGER, REVA KATHLEEN
Entity Type:Individual
Prefix:MRS
First Name:REVA
Middle Name:KATHLEEN
Last Name:BIEGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:KY
Mailing Address - Zip Code:41008-1354
Mailing Address - Country:US
Mailing Address - Phone:502-732-5154
Mailing Address - Fax:
Practice Address - Street 1:712 BUTLER ST
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:KY
Practice Address - Zip Code:41008-1354
Practice Address - Country:US
Practice Address - Phone:502-732-5154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management