Provider Demographics
NPI:1669775953
Name:REICH, JULIE VAUGHN (BCBA)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:VAUGHN
Last Name:REICH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 KELMAR AVE
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-1513
Mailing Address - Country:US
Mailing Address - Phone:484-467-0461
Mailing Address - Fax:
Practice Address - Street 1:86 KELMAR AVE
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-1513
Practice Address - Country:US
Practice Address - Phone:484-467-0461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst