Provider Demographics
NPI:1073165635
Name:NEVELLS, KRISTEN (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:NEVELLS
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:SOUDERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18964-1853
Mailing Address - Country:US
Mailing Address - Phone:215-262-0591
Mailing Address - Fax:
Practice Address - Street 1:313 PENN AVE
Practice Address - Street 2:
Practice Address - City:SOUDERTON
Practice Address - State:PA
Practice Address - Zip Code:18964-1853
Practice Address - Country:US
Practice Address - Phone:215-262-0591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-14
Last Update Date:2019-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst