Provider Demographics
NPI:1285309773
Name:KNERR, CHASITY AIREANNA (RBT)
Entity type:Individual
Prefix:
First Name:CHASITY
Middle Name:AIREANNA
Last Name:KNERR
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2081 RT 61
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:PA
Mailing Address - Zip Code:17801-6166
Mailing Address - Country:US
Mailing Address - Phone:570-847-1106
Mailing Address - Fax:
Practice Address - Street 1:123 URBAN RD
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:PA
Practice Address - Zip Code:17830-7225
Practice Address - Country:US
Practice Address - Phone:570-847-1106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician