Provider Demographics
NPI:1396569919
Name:KRASNOW, REVA (MS-ED BCBA)
Entity type:Individual
Prefix:
First Name:REVA
Middle Name:
Last Name:KRASNOW
Suffix:
Gender:F
Credentials:MS-ED BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 BERNARD DR
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-1966
Mailing Address - Country:US
Mailing Address - Phone:818-853-3068
Mailing Address - Fax:
Practice Address - Street 1:36 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-7034
Practice Address - Country:US
Practice Address - Phone:732-399-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst