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General NPI Number Information
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NPI Number | 1205311404
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Entity Type | Individual
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Provider Name | REBECCA ANNE REID-KONOVSEK BCBA-D
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Gender | Female
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Dates
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Enumeration Date | 10/03/2018
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 15214 CLEAR ST
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City | NOBLESVILLE
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State | IN
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Zip | 46060-4688
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Country | US
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Telephone | 260-227-0972
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Fax |
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Provider Business Mailing Address
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Address Line | 2890 CARPENTER RD
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City | ANN ARBOR
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State | MI
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Zip | 48108-1100
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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