Provider Demographics
NPI:1578185344
Name:KOTHAPALLI, RADHIKA (MA,BCBA,LBS)
Entity Type:Individual
Prefix:
First Name:RADHIKA
Middle Name:
Last Name:KOTHAPALLI
Suffix:
Gender:F
Credentials:MA,BCBA,LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 FOLKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1927
Mailing Address - Country:US
Mailing Address - Phone:412-877-0465
Mailing Address - Fax:
Practice Address - Street 1:110 FORT COUCH RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1030
Practice Address - Country:US
Practice Address - Phone:412-831-1223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-14
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-12-10037103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst