Provider Demographics
NPI:1154848471
Name:RYAN, REBECCA (BCBA, LBS)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:RYAN
Suffix:
Gender:F
Credentials:BCBA, LBS
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:CHAIT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:200 SKILES BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-7321
Mailing Address - Country:US
Mailing Address - Phone:610-455-4040
Mailing Address - Fax:855-251-8777
Practice Address - Street 1:200 SKILES BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-7321
Practice Address - Country:US
Practice Address - Phone:610-455-4040
Practice Address - Fax:855-251-8777
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-16-14374106S00000X
PA1-20-41146103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician