Provider Demographics
NPI:1629486568
Name:KUNKLE, BREANN (MS, BCBA, LBS)
Entity type:Individual
Prefix:
First Name:BREANN
Middle Name:
Last Name:KUNKLE
Suffix:
Gender:F
Credentials:MS, BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238A FRIENDSHIP AVE
Mailing Address - Street 2:
Mailing Address - City:HELLAM
Mailing Address - State:PA
Mailing Address - Zip Code:17406-9063
Mailing Address - Country:US
Mailing Address - Phone:610-751-5345
Mailing Address - Fax:
Practice Address - Street 1:238A FRIENDSHIP AVE
Practice Address - Street 2:
Practice Address - City:HELLAM
Practice Address - State:PA
Practice Address - Zip Code:17406-9063
Practice Address - Country:US
Practice Address - Phone:610-751-5345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
PA1-23-68728103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor