Individual
KRISTEN KENIMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
6865 PARKDALE PL, INDIANAPOLIS, IN 46254-5654
(317) 299-5437
Mailing address
6636 W OHIO ST, INDIANAPOLIS, IN 46214-3977
(765) 434-1145
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-23675
IN
Other
Enumeration date
09/28/2016
Last updated
04/16/2019
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