MEDICARE: RITA CHRISTOPHER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-15-21070

General Provider Information

NPI Number	:	1851757397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RITA CHRISTOPHER

Provider Business Mailing Address
First Line	:	55 ALEXANDRA CT
Second Line	:
City	:	MARLTON
State	:	NJ
Zip	:	08053-2742
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 S BURNT MILL RD STE D
Second Line	:
City	:	VOORHEES
State	:	NJ
Zip	:	08043-2205
Country	:	US
Telephone Number	:	888-859-7749
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2016
Last Update Date	:	08/12/2021

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