Provider Demographics
NPI:1578824371
Name:KAMMERER, DEBRA (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:KAMMERER
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1160 MCDERMOTT DR # 214
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-4022
Mailing Address - Country:US
Mailing Address - Phone:610-430-5678
Mailing Address - Fax:
Practice Address - Street 1:1160 MCDERMOTT DR # 214
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-4022
Practice Address - Country:US
Practice Address - Phone:610-430-5678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst