Provider Demographics
NPI:1801574033
Name:REVOLI, DREEAHNY JABREE
Entity type:Individual
Prefix:
First Name:DREEAHNY
Middle Name:JABREE
Last Name:REVOLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 GULFSTREAM BLVD
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33444-4306
Mailing Address - Country:US
Mailing Address - Phone:561-251-8857
Mailing Address - Fax:
Practice Address - Street 1:320 GULFSTREAM BLVD
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33444-4306
Practice Address - Country:US
Practice Address - Phone:561-251-8857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician