Provider Demographics
NPI:1073042214
Name:CLOYD, RENEE ASHLEY (MA BCBA)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:ASHLEY
Last Name:CLOYD
Suffix:
Gender:F
Credentials:MA BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 NESTINGROCK LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19054-3809
Mailing Address - Country:US
Mailing Address - Phone:215-932-7400
Mailing Address - Fax:
Practice Address - Street 1:51 NESTINGROCK LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19054-3809
Practice Address - Country:US
Practice Address - Phone:215-932-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-10
Last Update Date:2017-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-17-25544103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst